Single course of antenatal steroids associated with small increased incidence of serious infection in infants

Clinical Question

Is exposure to a single course of antenatal corticosteroids associated with increased incidence of serious infection within 12 months of life?

Bottom line

This large cohort study suggests that a single course of antenatal corticosteroids is associated with a small, but statistically significant, increase in the incidence of serious infection during the first year of life. This should be weighed against the known benefit for the prevention of respiratory distress syndrome among preterm neonates. The overall risk is higher for infants born preterm versus full term, but the more important argument is that the hazard ratio is higher for full term than for preterm, indicating that the increased risk of steroids might be more pronounced in infants who receive treatment and are then born full term. 2b

Study design: Cohort (retrospective)

Funding: Government

Setting: Population-based

Reviewer

Linda Speer, MD
Professor and Chair, Department of Family Medicine
University of Toledo
Toledo, OH


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Comments

Anonymous

Antenatal Steroids

'The investigators used propensity scoring to account for systematic baseline differences between groups'
One thing that cannot be accounted for is that each of these pregnancies had a reason for administering steroids. What were the indications? These may also affect infant health.

ARUP KUMAR DHARA

Impact assessment

Excellent