Poster Session 2
Category: Prematurity
Poster Session 2
Shayna Miodownik, MD, MSc
Soroka University Medical Center
Soroka University Medical Center, HaDarom, Israel
Tamar Wainstock, PhD (she/her/hers)
Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, 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 corticosteroid (ACS) administration in anticipation of preterm birth is a well-established intervention, shown to significantly improve neonatal outcomes. However, many exposed fetuses are delivered at term, raising concerns about potential long-term effects. This study assessed long-term infectious morbidity in term-born offspring exposed to ACS before 34 weeks’ gestation, compared to unexposed controls.
Study Design:
A population-based cohort study was conducted. Offspring born at term were categorized based on ACS exposure prior to 34 weeks gestation. Data were collected from ambulatory and hospitalization records and the incidence of infectious morbidity in offspring up to age 18 years was compared. A Kaplan–Meier survival analysis assessed cumulative infectious incidence, and a Cox proportional hazards model adjusted for potential confounders.
Results:
Among 182,626 neonates born at term, 2,093 were exposed to ACS prior to 34 weeks gestation. Term-born offspring exposed to ACS demonstrated a higher rate of long-term infectious morbidity (324 vs. 187 cases per 1,000 follow-up years; p</em> < 0.001), particularly neonatal infections, viral infections, bronchiolitis, and ear, nose and throat (ENT) infections (Table). Kaplan–Meier analysis demonstrated a significantly increased cumulative incidence in the ACS-exposed group (p-value < 0.001, Figure). In a Cox regression analysis, which controlled for maternal and gestational age, diabetes mellitus, hypertensive disorders and cesarean delivery, ACS exposure was independently associated with infectious morbidity (aHR=1.116, 95% CI 1.08-1.14, p</em>-value < 0.001). In a subgroup analysis for early term, the results remained significant.
Conclusion:
ACS exposure is associated with a significantly increased risk of long-term infectious morbidity in term-born infants. These findings underscore the importance of ongoing evaluation of ACS use and highlight the need for careful patient selection and adherence to clear indications when considering ACS, particularly in pregnancies that may reach term.