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Hypertension

Poster Session 1

(262) Antenatal Corticosteroid Exposure in those with Hypertensive Disorders of Pregnancy: A Population Cohort Study

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Sarah Nazeer, MD (she/her/hers)

    Maternal-Fetal Medicine Fellow
    McGovern Medical School at UTHealth Houston
    Houston, TX, United States

    • Coauthor(s)

  • HC

    Han-Yang Chen, PhD

    Department of Obstetrics, Gynecology and Reproductive Sciences
    The University of Texas Health Science Center at Houston
    Houston, TX, United States

  • Suneet P. Chauhan, MD

    Professor
    University of Texas-Houston Medical School
    Houston, TX, United States

  • Ghamar Bitar, MD

    McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
    Houston, TX, United States

  • Farah H. Amro, MD

    Assistant Professor
    McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth)
    Houston, TX, United States

  • SB

    Sean C. Blackwell, MD

    Professor
    Children's Memorial Hermann Hospital
    Houston, TX, United States

  • Baha M. Sibai, MD

    Professor
    Hermann Memorial Hospital
    Houston, TX, United States

  • Michal Fishel Bartal, MD (she/her/hers)

    Maternal Fetal Medicine Faculty
    McGovern Medical School at UTHealth Houston, Sheba Medical Center, Tel Hashomer, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
    Houston, TX, United States

Objective:

To examine the association between antenatal corticosteroid (ANCS) exposure and adverse neonatal outcomes among those with hypertensive disorders of pregnancy (HDP) who delivered in the late preterm period.

Study Design:

This population-based, retrospective cohort study used U.S. Vital Statistics dataset between 2016-2020. Inclusion criteria were those with a diagnosis of HDP (defined as chronic hypertension, gestational hypertension, pre eclampsia and eclampsia), who delivered between 34.0 to 36.6 weeks gestation and known ANCS exposure status. The primary outcomes were a composite neonatal adverse outcome, included: Apgar score < 5 at 5 minutes, immediate assisted ventilation, assisted ventilation > 6 hours, surfactant use, seizure, neonatal or infant mortality. Multivariable Poisson regression models with robust error variance were used to estimate adjusted relative risks (aRR) and 95% confidence intervals (CI).

Results:

Between 2016-2020, upwards of 19 million live births occurred in the U.S. Of those, 182,014 (1%) met our inclusion criteria and among them, 130,133 (71.5%) did not receive ANCS and 51,881 (28.5%) received ANCS. After adjustment, the risk of composite neonatal morbidity (aRR 1.32, 95% CI 1.30-1.35) was significantly higher among those with HDP who received ANCS compared to those without ANCS exposure. A subgroup analyses in those with preexisting hypertension, also showed an increase in both neonatal adverse outcome (aRR 1.36, 95% CI 1.30-1.42).

Conclusion:

In pregnancies with HDP and delivery in the late preterm period, the risk of composite neonatal morbidity was higher in those with ANCS exposure compared to those without ANCS administration. These findings suggest further need of trials investigating the role of ANCS in those with HDP.