Antenatal Corticosteroids in Preterm Infants: A Gestational Age-Based Comparison of Respiratory Outcomes

Abstract

Background

Dexamethasone is an antenatal corticosteroid injected into mothers at risk of preterm labor (usually 24–34 weeks) to accelerate fetal lung maturation, significantly reducing risks of neonatal death, respiratory distress syndrome, and intraventricular hemorrhage. It acts by stimulating surfactant production.

Study Objectives

To determine the association between the administration of antenatal corticosteroids and the prevalence of respiratory distress syndrome among preterm neonates delivered at Al Mocha Hospital, Taiz Governorate (From January 1, 2023, to June 30, 2025).

Study Design

The research work was designed as a retrospective cohort study.

Subjects and Methods

A questionnaire was constructed for this study, which included information on maternal age, place of residence, gravidity, antenatal care visits, dexamethasone administration rate, gestational age at delivery, mode of delivery, diagnosis of RDS, and other neonatal complications. This information was recorded and analyzed using SPSS software.

Results

 Two groups were studied: a study group (50) pregnant women who received dexamethasone upon hospital admission for preterm labor, and a control group (50) women who did not receive dexamethasone. Their ages were between 20 and 30 years (70% in both groups). There were no statistically significant differences between the two groups in terms of place of residence or number of births. The number of women who did not seek antenatal care in the control group was twice that of the study group, 80% of the women in both groups experienced spontaneous preterm labor. The study group received four consecutive doses of dexamethasone (88%), two participants received two doses, and four participants received three consecutive doses. There were 86% of the women in both groups gave delivered between one and seven days after receiving the last dose of dexamethasone. Gestational age was between 28 and 32 weeks in 31% of the groups, and between 33 and 36 weeks in 69%, and 93% of the women delivered vaginally. The results of this study show that 32% of the neonates of the study group experienced respiratory distress syndrome compared to 54% of the control group. The statistical difference was significant (P=9.92) and 14% of neonates experienced severe RDS in the study group compared to 28% of the control group. All of these cases were admitted to the neonatal intensive care unit. Early neonatal deaths occurred in one child in the study group and two children in the control group, as 2% and 4% respectively.

Conclusion

The difference in the rate of RDS development between women exposed to steroids and the non-exposed group was statistically significant, and the majority completed their course of steroids. There was a stronger protective effect as when comparing infants of the same gestational age category, dexamethasone exposure reduces the odds of developing RDS by 69%. The severity of RDS among women not exposed to steroid was doubled compared with the exposed group. There was no increase in the rate of cesarean section among women delivered preterm. The Apgar score at 5 min. was better among the exposed group compared to the non-exposed group but did not reach to significant perinatal mortality was 30/1000 birth.