Rescue antenatal corticosteroids and neonatal outcomes in twin gestation

Roy Zigron, Ira Erlichman, Misgav Rottenstreich, Simcha Yagel, Joshua I. Rosenbloom, Shay Porat, Amihai Rottenstreich*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: Although repeated antenatal corticosteroids (ACS) courses are not recommended, a single rescue ACS course has been shown to decrease neonatal morbidity among preterm singletons. However, little is known regarding the effects of rescue ACS course in twin pregnancies. Methods: A retrospective cohort study conducted during 2015–2017 at a tertiary-care center including all twins delivered between 24–34 weeks of gestation who received at least one course of ACS. Results: Overall, 162 (70.4%) twins were exposed to a single ACS course and 68 (29.6%) to an additional rescue ACS course. Rescue ACS course was associated with lower rates of respiratory distress syndrome (7.4% vs. 19.1%, p =.03), surfactant use (7.4% vs 18.5%, p =.04) and bronchopulmonary dysplasia (0 vs 8.6%, p =.01) as compared to a single ACS course. In the rescue ACS group, compared to the single ACS group, the rates of composite respiratory adverse outcome (10.3% vs 22.2%, OR [95% CI]: 0.40 (0.17–0.95), p =.04) and any adverse neonatal outcome (13.2% vs 26.5%, OR [95% CI]: 0.42 (0.19–0.92), p =.04) were significantly lower. Hospital stay was also shorter among neonates born to mothers receiving a rescue ACS course (median 23 vs. 30 days, p =.01). No differences were noted in neonatal birthweight, head circumference and the rate of neonatal hypoglycemia. Conclusion: Rescue ACS course was associated with improved respiratory and neonatal outcomes in twin gestations. Further studies are warranted to confirm our findings and better delineate the optimal regimen of rescue ACS in this setting.

Original languageAmerican English
Pages (from-to)7337-7343
Number of pages7
JournalJournal of Maternal-Fetal and Neonatal Medicine
Volume35
Issue number25
DOIs
StatePublished - Dec 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.

Keywords

  • Antenatal corticosteroids
  • betamethasone
  • outcomes
  • preterm delivery
  • rescue
  • twins

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