Antenatal corticosteroid therapy in late preterm delivery: a nationwide population-based retrospective study in Taiwan

Objective To investigate whether antenatal corticosteroid therapy improves neonatal and maternal outcomes in late preterm delivery. Design Population-based retrospective study. Setting The linkages of Taiwan's National Health Insurance Research Database, National Birth Reporting Database, and the Taiwan Maternal and Child Health Database. Population All births at risk for late preterm deliveries in Taiwan between 2004 and 2011. Methods For every birth at risk for late preterm delivery, five controls randomly matched by maternal and gestational ages and birthweight were included. A conditional logistic regression analysis was applied for risk estimation, with births without corticosteroids as the reference group. Odds ratios were adjusted for caesarean section, parity, sex, gestational hypertension and gestational diabetes mellitus. Main outcome measures Neonatal outcomes, maternal outcomes and the utilisation of healthcare services. Results The outcomes of 5745 women treated with corticosteroids between 34(+0) weeks and 36(+6) weeks of gestation were compared with those of 28 135 untreated controls. Compared with the controls, births from women administered corticosteroids reduced the need for continuous positive airway pressure, the number of neonatal intensive care unit admission, and the need for glucose administration, as well as the risk of neonatal respiratory distress, but increased the risk of neonatal sepsis and the number of outpatient visits. Conclusions Antenatal corticosteroid therapy in women at risk of late preterm delivery may significantly reduce the need for respiratory support and glucose supply, and respiratory complication risk in neonates. Tweetable abstract Antenatal corticosteroids in late preterm delivery reduced the risk of neonatal respiratory complications in Taiwan.