Antenatal steroids, condition at birth and respiratory morbidity and mortality in very preterm infants

Aims: To investigate (1) perinatal factors affecting condition at birth in very preterm infants (23-32 weeks) and (2) the relationship between poor condition at birth and neonatal respiratory morbidity and mortality. Methodology: Convenience sample (n = 479) drawn from a geographic population inception cohort. Results: Antenatal steroid use reduced the risk of pH less than or equal to 7.20 [Adjusted Odds Ratio 0.29 (95% CI 0.17,0.50)], one minute Apgar <4 [0.54 (0.33,0.88)], and 5 min Apgar <7 [0.44 (0.23,0.84)]. Gestational age was significantly related to Apgar score but not cord arterial acid-base status. No other perinatal factor was significant. Poor condition at birth was associated with an increase in the incidence and severity of hyaline membrane disease and death. These effects were lessened in those exposed to steroids. Conclusion: Antenatal steroid use is associated with improved condition at birth and reduces the deleterious effects of poor condition at birth on early respiratory morbidity and mortality.