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Archives of Gynecology and Obstetrics

, Volume 298, Issue 4, pp 689–695 | Cite as

Neonatal outcome in gestational-diabetic mothers treated with antenatal corticosteroids delivering at the late preterm and term

  • Eyal Krispin
  • Alyssa Hochberg
  • Rony Chen
  • Arnon Wiznitzer
  • Eran Hadar
  • Adi Borovich
Maternal-Fetal Medicine
  • 51 Downloads

Abstract

Objective

To determine the association between antenatal corticosteroid treatment and neonatal complications in diabetic mothers delivering after 34 weeks of gestation.

Methods

A retrospective cohort study of women with singleton pregnancies diagnosed with gestational diabetes who delivered after 34 weeks of gestation in a university-affiliated medical center (2012–2016). Mothers treated with corticosteroids prior to 34 + 0 weeks of gestation were divided according to gestational age at delivery: late-preterm (34 + 0 to 36 + 6) and term (37 + 0 to 41 + 6). Each group was compared to women delivering at the same gestational age who were not treated with corticosteroids. Primary outcome was defined as a neonatal adverse composite outcome. Birth weight was amongst secondary outcomes measured. Logistic regression analysis was utilized to adjust results to potential confounders.

Results

During the study period, 161 diabetic mothers delivered at late-preterm. Amongst them, 47 (30%) were treated with corticosteroids. 2101 diabetic mothers delivered at term, amongst them 82 (4%) were treated with corticosteroids. Primary outcome did not differ between groups. Multivariate analysis demonstrated that corticosteroid treatment was not associated with neonatal adverse composite outcome when delivery occurred at the late preterm, nor at term (adjusted odds ratio (aOR) = 0.708, 95% CI 0.2–2.3, p = 0.572, and aOR = 1.6, 95% CI 0.2–12.7, p = 0.635, respectively). Birth weight was significantly lower in women treated with corticosteroids (2486 vs. 2675 g, p = 0.02 at late-preterm, and 3160 vs. 3319 g, p < 0.001 at term).

Conclusion

Corticosteroid treatment for diabetic mothers was not associated with neonatal adverse outcomes, but was found associated with a lower birth weight, when delivery occurs after 34 weeks of gestation.

Keywords

Antenatal corticosteroids Gestational diabetes mellitus Late preterm Term 

Abbreviations

ACS

Antenatal corticosteroid

RDS

Respiratory distress syndrome

TTN

Transient tachypnea of the newborn

GDM

Gestational diabetes mellitus

NICU

Neonatal intensive care unit

GCT

Glucose challenge test

OGTT

Oral glucose tolerance test

Notes

Author contributions

EK: protocol development, data analysis and manuscript writing. AH: manuscript writing, data analysis. RC: protocol development and manuscript editing. AW: protocol development and manuscript editing. EH: protocol development and manuscript editing. AB: protocol development, data analysis and manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Human and animal rights statement

This article does not contain any studies with animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyHelen Schneider Hospital for Women, Rabin Medical CenterPetach TikvaIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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