Long-Term Neurodevelopmental Outcomes After Antenatal Corticosteroid Therapy in Late Preterm Twins: A Nationwide Retrospective Cohort Study.

Abstract

Background: In women with singleton pregnancy who are at risk of late preterm delivery, administration of antenatal corticosteroids is recommended to reduce neonatal respiratory complications. However, the adoption of this practice is not widely accepted in twin pregnancies because of a lack of evidence regarding both the effectiveness and long-term safety of corticosteroids. This study was conducted to evaluate the long-term neurodevelopmental outcomes of twins according to the administration of antenatal corticosteroid in late preterm.

Methods: This nationwide population based retrospective cohort study included twins who were delivered late preterm (34+0-36+6 weeks) between 2007 and 2010. The study population were divided into 2 groups according to the administration of preterm antenatal corticosteroids. Group 1 included twins from mothers who were administered antenatal corticosteroids in late preterm (with late preterm corticosteroids), and group 2 included twins whose mothers were not administered antenatal corticosteroid (without corticosteroids). The risk of long-term adverse neurodevelopmental outcomes was compared between the 2 groups. The composite adverse neurodevelopmental outcome was defined as the occurrence of at least one of the following: autism, cerebral palsy, speech articulation disorder, developmental disorders of scholastic skills, or developmental disorders of motor function.

Results: During the study period, 9,450 children met the inclusion criteria: 1,476 children in group 1 (with late preterm corticosteroids) and 7,974 children in group 2 (without corticosteroids). There was no statistically significant difference in the long-term adverse neurodevelopmental outcomes between the 2 groups. This result was consistent even after adjusting for covariates (adjusted hazard ratio 0.973 [95% confidence interval, 0.811-1.166]).

Conclusion: The risk of long-term adverse neurodevelopmental outcomes did not increase after antenatal corticosteroid administration in twin children who were born in late preterm.