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Prematurity

Poster Session 3

(848) Outcomes in Pregnancies Complicated with Preterm Hypertensive Disorders with and without Late Antenatal Corticosteroids

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: To determine whether late preterm (34-36 weeks) course of antenatal corticosteroids (ACS) is associated with improved short-term neonatal outcomes among pregnancies complicated with hypertensive disorders of pregnancy (HDP) who delivered in the late preterm period.

Study Design: A single tertiary center retrospective study (11/2011 to 05/2023), including all individuals with singleton, non-anomalous fetuses who delivered between 34.0-36.6 weeks of gestation following a diagnosis of HDP. Individuals with missing delivery data and those who received only a single dose of ACS were excluded. The primary outcome was a composite adverse neonatal outcome, including intensive care unit (NICU) admission, oxygen treatment, non-invasive positive pressure ventilation, mechanical ventilation, respiratory distress syndrome, or transient tachypnea of the newborn. Secondary neonatal outcomes included Apgar score, intraventricular hemorrhage, surfactant use, hypoglycemia, hyperbilirubinemia, and sepsis. Multivariable regression models were used to estimate adjusted odds ratio (aOR) and 95% confidence intervals (CI).

Results: Of 7624 preterm deliveries during the study period, 262 (3.4%) individuals were diagnosed with HDP and delivered between 34+0 to 36+6 weeks. Of them, 73 (28%) received ACS in the late preterm period. Those treated with ACS were more likely to have a history of HDP (12.3% vs. 5.3%, p=0.05), to be diagnosed with fetal growth restriction (19.2% vs. 7.4%, p=0.006), delivered earlier (35.4 vs. 36.1 weeks, p=0.001), and to have a Cesarean delivery (67.1% vs. 48.9%, p=0.008). After adjustments, the composite neonatal morbidity was similar between the two groups (aOR 0.87, 95% CI 0.44,1.72). Other secondary outcomes, including hypoglycemia requiring treatment, were also similar between the groups (Table).

Conclusion:

Exposure to a late preterm ACS does not improve neonatal morbidity in newborns born in the late preterm period following HDP. Additional studies with larger cohorts in this specific population are required.