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Recording available 2/16-5/2
Recording available 2/16-5/2
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Poster Session 2

Category: Prematurity

Poster Session 2

(416) Preterm Birth After Antenatal Corticosteroid Treatment: Associations with Long-Term Infectious Diseases

Wednesday, February 11, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Amir Snir, MD

    Soroka University Medical Center
    omer, HaDarom, Israel

    • Coauthor(s)

  • 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 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

  • 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

Objective:
Antenatal corticosteroids (ACS) are routinely administered to pregnancies at risk for preterm birth due to their proven benefits in reducing neonatal morbidity and mortality. However, the long-term effects of ACS in this population are not fully understood. We aimed to evaluate the risk of childhood infectious morbidity among premature infants born following ACS exposure before 34 weeks.

Study Design:

A population based cohort study was conducted at a tertiary referral center, including singleton preterm births (< 37 weeks gestation) between 1991 and 2021. Long-term infectious morbidity of preterm offspring who were exposed to ACS prior to 34 weeks gestation was compared with unexposed children, based on combined databases from both community and hospitalization records. Cumulative incidence was estimated using Kaplan–Meier survival curves and Cox proportional hazards models were employed to adjust for potential confounders.

Results:

Among 13,580 preterm births, 1,538 neonates (11.3%) were exposed to ACS before 34 weeks gestation. The incidence of infectious morbidities was significantly higher in the exposed group (387.6 vs. 177.5 per 1,000 person years, Table; Kaplan–Meier log-rank p< 0.001; Figure). In a multivariable Cox model, adjusting for maternal age, mode of delivery, hypertensive disorders, diabetes mellitus, and gestational age, ACS exposure remained independently associated with increased risk for long term infectious morbidity of the offspring (aHR=1.15; 95% CI 1.11–1.19; p< 0.001). Subgroup analyses by gestational age demonstrated consistent findings, with the strongest association observed among extremely preterm infants (< 28 weeks, Kaplan–Meier log-rank p< 0.001; Figure).

Conclusion:
ACS exposure before 34 weeks of gestation was associated with increased risk of infectious morbidity in children born preterm. While ACS remains essential in managing threatened preterm birth, this association may partly reflect indication bias, as more vulnerable fetuses are more likely to receive treatment. Further research is warranted to clarify long-term outcomes and guide clinical decision-making.