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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (1): 79-84    DOI: 10.31083/j.ceog.2021.01.2250
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The association between antenatal corticosteroid use in late-preterm and early-term pregnancy and nonreassuring fetal status
Ji Eun Park1, Ji Kwon Park2, *(), Hyun Chul Jo1, In Ae Cho3, Jong Chul Baek1
1Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University, Gyeongsang National University Changwon Hospital, 52828 Changwon, Republic of Korea
2Department of Obstetrics and Gynecology, Hanmaeum Medical Center, 110-744 Changwon, Republic of Korea
3Department of Obstetrics and Gynecology, College of Medicine, Gyeongsang National University Hospital, 52727 Jinju, Republic of Korea
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Abstract  
This study aimed to compare perinatal outcomes, including nonreassuring fetal status, according to antenatal corticosteroid therapy (ACT) use during late-preterm and early-term pregnancies. This was a retrospective cohort study of women with singleton pregnancies who were at risk of late-preterm (34-36+6 weeks) birth or early-term (37-38+6 weeks) scheduled cesarean section from August 2017-July 2019. ACT was administered until June 2018, after which a policy was implemented such that ACT was not used for pregnant women in the above circumstances. Women were grouped based on whether they delivered before or after the policy change and were subdivided into late-preterm birth and early-term scheduled cesarean section groups to reduce variations in newborn outcomes. Multivariable logistic regression was used to determine whether the use of antenatal corticosteroids increased the odds of perinatal outcomes. In total, 216 women (215 neonates, 1 stillborn) were included. In the late-preterm delivery group, the rate of nonreassuring fetal status was significantly higher in the antenatal corticosteroid group than in the non-corticosteroid group (33.3% vs 12.0%, P = 0.017). In the early-term delivery group, the rate was non-significantly higher in the antenatal corticosteroid use group (19.0% vs 6.3%, P = 0.091). In the multivariable logistic regression, ACT was associated with an increased risk of nonreassuring fetal status (P = 0.025) and a reduced incidence of transient tachypnea of the newborn (TTN) (P = 0.011). We determined for the first time that ACT in late-preterm and early-term pregnancy is associated with nonreassuring fetal status. Here, ACT in late-preterm and early-term pregnancy had no benefit beyond decreasing the TTN rate.
Key words:  Antenatal corticosteroid      Late-preterm pregnancy      Early-term pregnancy      Nonreassuring fetal status      Transient tachypnea of the newborn     
Submitted:  04 August 2020      Revised:  18 September 2020      Accepted:  20 October 2020      Published:  15 February 2021     
*Corresponding Author(s):  Ji Kwon Park     E-mail:  obgypjk@gnu.ac.kr

Cite this article: 

Ji Eun Park, Ji Kwon Park, Hyun Chul Jo, In Ae Cho, Jong Chul Baek. The association between antenatal corticosteroid use in late-preterm and early-term pregnancy and nonreassuring fetal status. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 79-84.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.01.2250     OR     https://ceog.imrpress.com/EN/Y2021/V48/I1/79

[1] K.P. Fuller, S. DeGroff, A.F. Borgida. Neonatal outcomes based on antenatal corticosteroid exposure time for infants delivered between 23 and 34 weeks gestation[J]. Clinical and Experimental Obstetrics & Gynecology, 2017, 44(2): 247-251.
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