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Long-term outcomes of antenatal corticosteroids treatment in very preterm infants after chorioamnionitis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the effect of antenatal corticosteroids (AC) therapy on short- and long-term outcomes among very low birth weight preterm infants after histologic chorioamnionitis (HCA).

Methods

We performed a retrospective analysis of 5240 single very low birth weight (VLBW) infants born at 22 + 0 and 33 + 6 weeks of gestation between 2003 and 2007, who registered to the Neonatal Research Network Japan. The effects of AC therapy on mortality, neurodevelopmental outcomes at 3 years of age and neonatal morbidities were analyzed in the groups with or without HCA using logistic regression analysis.

Results

In the study subjects, 840 were with HCA, 2734 were without HCA, and 1666 were excluded without data for HCA. AC therapy was significantly associated with decreasing mortality before 3 years of age; [0.52 (0.32–0.86)], [odds ratio (95 % confidence intervals]. There were no differences between the two groups regarding neurodevelopmental outcomes, including cerebral palsy [0.90 (0.41–1.99)], development quotient <70 [0.93 (0.48–1.81)], visual impairment [0.46 (0.04–5.18)], and severe hearing impairment [4.00 (0.30–53.4)] in the group with HCA as well as without HCA. Regarding neonatal morbidities, AC therapy was associated with a lower incidence of respiratory distress syndrome [0.67 (0.50–0.91)], sepsis [0.62 (0.41–0.94)], late-onset adrenal insufficiency [0.62 (0.39–0.98)] and an increased incidence of chronic lung disease [1.62 (1.18–2.24)] in the group with HCA. In the group without HCA, AC therapy was associated with decreasing respiratory distress syndrome [0.60 (0.43–0.84)] and increasing chronic lung disease [1.34 (1.11–1.62)].

Conclusion

AC therapy is significantly associated with reduced mortality before 3 years of age in VLBW infants with HCA, but not with neurodevelopmental outcomes, which was same as the results found in infants without HCA. AC therapy is recommended for women with suspected chorioamnionitis, as well as those without chorioamnionitis.

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Acknowledgments

We thank the institutions and representative physicians enrolled in the Neonatal Research Network Database in Japan, which include: Sapporo City General Hospital: S. Hattori; Kushiro Red Cross Hospital: A. Noro; Aomori Prefectural Central Hospital: T. Amizuka; Iwate Medical University: S. Chida; Sendai Red Cross Hospital: R. Takahashi; Akita Red Cross Hospital: H. Arai; Fukushima Medical University: T. Imamura; National Fukushima Hospital: N. Ujiie; University of Tsukuba: Y. Miyazono; Tsuchiura Kyodo General Hospital: J. Shimizu; Dokkyo Medical University: H. Suzumura; Jichi Medical University: Y. Kono; Saitama Children’s Medical Center: M. Shimizu; Saitama Medical University Saitama Medical Center: T. Kunikata; Gunma Children’s Medical Center: T. Fujiu; Kameda Medical Center: H. Sato; Tokyo Women’s Medical University Yachiyo Medical Center: T. Kondo; Tokyo Metropolitan Bokuto Hospital: T. Watanabe; Showa University: M. Aizawa; Tokyo Women’s Medical University: A. Uchiyama; Nihon University Itabashi Hospital: M. Makimoto; Teikyo University: J. Hoshi; Toho University: H. Yoda; Japan Red Cross Medical Center: Y. Kawakami; Aiiku Hospital: N. Ishii; National Center for Child Health and Development: Y. Ito; Kanagawa Children’s Medical Center: H. Itani; Yokohama City University Medical Center: K. Seki; Tokai University: M. Nomura; Kitazato University: M. Nowatari; Yamanashi Prefectural Central Hospital: A. Nemoto; Nagaoka Red Cross Hospital: O. Nagata; Niigata City Hospital: Y. Nagayama; Nagano Children’s Hospital: T. Nakamura; Shinshu University: M. Okada; Iida City Hospital: S. Nakata; National Nagano Hospital: E. Shimazaki; Saku General Hospital: T. Yoda; Toyama Prefectural Central Hospital: T. Hutatani; Ishikawa Prefectural Central Hospital: Y. Ueno; Fukui Prefectural Hospital: K. Iwai; Shizuoka Children’s Hospital: Y. Nakazawa; Seirei Hamamatsu General Hospital: S. Oki; Nagoya Red Cross First Hospital: C. Suzuki; National Mie Hospital: M. Bonno; Gifu Prefectural Central Hospital: Y. Kawano; Otsu Red Cross Hospital: K. Nakamura; Kyoto Red Cross First Hospital: N. Mitsufuji; Osaka Medical Center and Research Institute for Maternal and Child Health: J. Shiraishi; Osaka City General Hospital: H. Ichiba; Takatsuki Hospital: H. Minami; Yodogawa Christian Hospital: H. Wada; Kansai Medical University: A. Ohashi; Aizenbashi Hospital: K. Sumi; Nara Medical University: Y. Takahashi; Wakayama Prefectural Medical University: T. Okutani; Hyogo Prefectural Kobe Children’s Hospital: S. Yoshimoto; Tottori University: I. Nagata; Shimane Prefectural Central Hospital: E. Kato; Kurashiki Central Hospital: S. Watabe S; National Okayama Hospital: M. Kageyama; Hiroshima Prefectural Hospital: R. Fukuhara; Hiroshima City Hospital: M. Hayashitani; Yamaguchi Prefectural Medical Center: K. Hasegawa; National Kagawa Children’s Hospital: A. Ohta; Kagawa University: T. Kuboi; Ehime Prefectural Central Hospital: S. Akiyoshi; Kochi Health Sciences Center: K. Kikkawa; Tokushima University: T. Saijo; St. Mary’s Hospital: S. Shimokawa; Kitakyushu City Municipal Medical Center: N. Matsumoto; Kurume University: H. Kanda; Fukuoka University: E. Oota; National Kyushu Medical Center: G. Kanda; Kyushu University: M. Ochiai; National Nagasaki Medical Center: M. Aoki; Kumamoto City Hospital: Y. Kondo; Kumamoto University: M. Iwai; Oita Prefectural Hospital: K. Iida; Miyazaki University: T. Ikenoue; Kagoshima City Hospital: S. Ibara; Okinawa Chubu Hospital: M. Kohama.

Conflict of interest

This study was partly supported by a Grant from the Ministry of Health, Labor and Welfare, Japan (H16-kodomo-ippan-032, H19-kodomo-ippan-005, H22-jisedai-ippan-006).

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Japanese Red Cross Nagoya Daiichi Hospital, 3-15 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan

    Ken Miyazaki & Madoka Furuhashi

  2. Department of Endowed Chair for Regeneration of Medicine in Kuwana District, Suzuka University of Medical Science, Mie, Japan

    Kaoru Ishikawa

  3. Department of Nursing, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Koji Tamakoshi

  4. Department of Obstetrics and Gynecology, Kochi Health Sciences Center, Kochi, Japan

    Kazutoshi Hayashi

  5. Department of Neonatology, Aizenbashi Hospital, Osaka, Japan

    Akihiro Kai

  6. Department of Obstetrics, Kanagawa Children’s Medical Center, Yokohama, Japan

    Hiroshi Ishikawa

  7. Department of Obstetrics and Gynecology, Mie University Graduate School of Medicine, Mie, Japan

    Nao Murabayashi & Tomoaki Ikeda

  8. Department of Pediatrics, Jichi Medical University, Tochigi, Japan

    Yumi Kono

  9. Department of Neonatology, Maternal and perinatal Center, Tokyo Women’s Medical University, Tokyo, Japan

    Satoshi Kusuda

  10. Department of Neonatology, Osaka Medical Center and Research Institute for maternal and Child Health, Osaka, Japan

    Masanori Fujimura

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  1. Ken Miyazaki
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  2. Madoka Furuhashi
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  5. Kazutoshi Hayashi
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  6. Akihiro Kai
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  7. Hiroshi Ishikawa
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  9. Tomoaki Ikeda
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  10. Yumi Kono
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  11. Satoshi Kusuda
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  12. Masanori Fujimura
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Corresponding author

Correspondence to Ken Miyazaki.

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Miyazaki, K., Furuhashi, M., Ishikawa, K. et al. Long-term outcomes of antenatal corticosteroids treatment in very preterm infants after chorioamnionitis. Arch Gynecol Obstet 292, 1239–1246 (2015). https://doi.org/10.1007/s00404-015-3762-6

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  • DOI: https://doi.org/10.1007/s00404-015-3762-6

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