EFFICACY OF ANTENATAL CORTICOSTEROIDS IN REDUCING NICU ADMISSIONS IN NEONATES DELIVERED BEFORE 37 WEEKS OF GESTATION: A PROSPECTIVE CLINICAL STUDY

Abstract

Currently, preterm birth is the most common cause of neonatal morbidity and mortality worldwide. Antenatal corticosteroids (ANC) are commonly given to prioritize making the baby’s lung mature and minimizing neonatal respiratory complications of the baby. The use of ANC is established for use between 24 and 34 weeks' gestation, but the value of ANC for the late preterm (34–36+6 weeks) remains a topic of ongoing research development. The main aim of this study is to evaluate the utility of ANC in preventing NICU admissions as well as morbidities in neonates less than 37 weeks of gestation.

Study design: A prospective, observational clinical study for six months was conducted at Akhtar Saaed Medical College and 120 pregnant women were included between 34 weeks (0 days) to 36 weeks (6 days of gestation) at high risk of preterm delivery. Betamethasone 12 mg was intramuscular for two consecutive days to eligible participants. The sample size was determined from the WHO sample size calculator, assuming 32% odds of NICU admission in the ANC group, 80%, 10% absolute precision, with an oversample to 120 for attrition, and a power of 0.95. Maternal demographics, obstetric history, delivery modeand neonatal outcomes (from NICU admission, RDS, TTN and hypoglycemia) were prospectively collected and analyzed by SPSS version 26.

Results: The NICU admissions in the ANC-treated group are statistically reduced (1.25 vs 1.32 in historical controls). We further analyzed respiratory parameters, RDS and TTN incidence and need for invasive respiratory support and found that they had been significantly improved. Comparative outcomes and delivery mode distributions are graphically represented (bar graphs and pie charts).

Conclusion: Neonatal outcomes and reduction in NICU admissions are associated with the use of ANC in late preterm pregnancies. These findings further support recent clinical guidelines and emphasize the need for changing protocols to include ANC provision for pregnancies at risk of late preterm delivery (1–4).