Multiple courses of antenatal corticosteroids are associated with early severe lung disease in preterm neonates

Beverly A. Banks, George Macones, Avital Cnaan, Jeffrey D. Merrill, Philip L. Ballard, Roberta A. Ballard, J. Pinto-Martin, B. Planer, M. McCarthy, E. Escobar, M. Morgan, E. Anday, K. Mooney, M. Johnson, W. Parer, R. Phibbs, N. Newton, J. Milar, J. Padbury, M. RossD. Polk, S. Harrington, D. Davis, K. Ash, J. Frank, E. Tyrala, L. Chan, J. Lioy, R. Librizzi, M. Hart, J. Garbaciak, E. Ramthun, S. Sawai, C. Carballo, F. Mannino, T. Moore, E. Milan, H. Schneider, D. Block, J. Keith, M. Rivera-Alsina, N. Ragavan, N. Dunn, V. Bhutani, S. Weiner, M. Grous

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objective: Determine whether the increased neonatal mortality following repeated courses of antenatal corticosteroids (ANCS), observed in the Thyrotropin-Releasing Hormone (TRH) Trial, was related to confounding maternal risk factors or specific preterm morbidities. Study Design: A post hoc analysis of 595 TRH trial neonates, 26 to 32 weeks' gestation, studied the association between ≥3 courses ANCS and mortality. Potential confounding maternal factors and preterm morbidities were evaluated using logistic regression and log likelihood modeling. Results: Mortality was 9.2% after ≥3 courses (13/141) vs. 4.8% after 1 or 2 courses (22/454). This association was not explained by maternal factors, or other common preterm morbidities. However, 15/141 infants receiving ≥3 courses (10.6%) had early severe lung disease (ESLD) with 10 deaths, compared to 16/454 of the 1- to 2-course infants (3.5%) with 7 deaths (odds ratio 3.5, p < 0.001). Conclusions. ESLD, but no maternal risk factors, was associated with increased mortality in preterm infants after ≥ 3 courses ANCS.

Original languageEnglish
Pages (from-to)101-107
Number of pages7
JournalJournal of Perinatology
Issue number2
StatePublished - 2002


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