Poster Session 2
Category: Prematurity
Poster Session 2
Dor Marciano, MBA, MD, MPH (he/him/his)
Resident
Soroka university medical center
Soroka, HaDarom, Israel
.jpg "Gali Pariente, MD photo")
Gali Pariente, MD
Acting director of Fetal Maternal Unit B Division of Obstetrics and Gynecology
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University
beer sheva, HaDarom, Israel
Tamar Wainstoc
Ben-Gurion University of the Negev
Beer Sheva, HaDarom, Israel
.jpeg.jpg "Eyal Sheiner, MD, PhD photo")
Eyal Sheiner, MD, PhD
Deichmann Lerner Full Professor of Obstetrics & Gynecology; Chairman of the Division of OBY&GYN
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
beer sheva, HaDarom, Israel
Antenatal corticosteroids (ACS) are routinely administered to mothers at risk for preterm delivery to reduce short-term neonatal complications. While their immediate benefits are well-established, less is known about long-term respiratory outcomes. This study aimed to evaluate the association between ACS exposure before 34 weeks, and long-term respiratory morbidity among preterm-born offspring (< 37 weeks), adjusting for gestational age at birth.
Study Design:
A retrospective population-based cohort study of all singleton preterm births at a tertiary medical center was conducted. Offspring were classified by ACS exposure before 34 gestational weeks. Respiratory-related community and hospital diagnoses were tracked from birth to 18 years. Incidence rates were calculated per 1,000 person-years. Kaplan–Meier curves compared cumulative respiratory morbidity. A Cox proportional hazards model estimated adjusted hazard ratios, controlling for gestational age at birth, maternal age, diabetes mellitus, pregnancy – related hypertensive disorders, and cesarean delivery.
Results:
Among 13,580 infants, 1,538 (11.3%) were ACS-exposed. These infants had lower mean gestational age (32.6 vs. 34.2 weeks; p < 0.001) and higher rates of cesarean delivery and hypertensive disorders. Respiratory morbidity incidence was higher in the exposed group (161.8 vs. 68.8 per 1,000 person-years; p < 0.001, Table), including asthma and obstructive sleep apnea. Kaplan–Meier analysis showed significantly higher cumulative incidence in the exposed group (p < 0.001; the strongest association was noted in infants born < 28 weeks (p < 0.001, Figure) ). In a Cox model, ACS exposure remained independently associated with long-term respiratory morbidity (aHR = 1.1; 95% CI, 1.03–1.13; p < 0.001).
Conclusion:
ACS exposure before 34 weeks is associated with increased long-term respiratory morbidity in preterm offspring, particularly among those born before 28 weeks. These findings underscore the importance of long-term follow-up in ACS-exposed children.