The Benefits and Risks of Multiple Courses of Antenatal Corticosteroid Therapy in Patients with Preterm Premature Rupture of Membranes / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: This study was performed to determine the benefits and risks of multiple courses of corticosteroids in patients with preterm premature rupture of membranes (PPROM). METHODS: We retrospectively evaluated the pregnancy and neonatal outcomes for women of singleton pregnancy with PPROM admitted at 24-32 weeks of gestation. Patients were categorized into 3 groups according to antenatal corticosteroids exposure (1) non-user group, (2) single-course group, (3) multiple-course group. Chi-square test, analysis of variances, Kruskal-Wallis test, and multiple logistic regression analysis were used for statistical analyses. RESULTS: A total of 170 patients were included, with 50 in non-use group, 76 in single-course group, and 44 in multiple-course group. Univariate analyses showed that clinical chorioamnionitis occurred in the highest incidence in multiple-course group (x2=6.20, p<0.05) and the decreased incidence of RDS in multiple-course group (x2=10.0, p<0.01). Multiple logistic regression analyses demonstrated that no significant association was found after adjustment of confounding variables (odds ratio=0.28, p=0.063) whereas multiple courses of corticosteroids were independently associated with clinical chorioamnionitis (odds ratio=13.15, p=0.025). CONCLUSION: Multiple courses of antenatal corticosteroids therapy did not reduce the incidence of RDS in neonates and were associated with increased risk of clinical chorioamnionitis in patients with PPROM.