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Antenatal corticosteroid therapy is associated with a lower risk of cystic periventricular leukomalacia
Author(s) -
Hershkovich Shporen Calanit,
Reichman Brian,
ZaslavskyPaltiel Inna,
LernerGeva Liat,
FlidelRimon Orna
Publication year - 2021
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.15772
Subject(s) - medicine , periventricular leukomalacia , bronchopulmonary dysplasia , odds ratio , intraventricular hemorrhage , pediatrics , confidence interval , low birth weight , population , birth weight , sepsis , gestational age , pregnancy , genetics , environmental health , biology
Aim To evaluate the association of antenatal corticosteroids (ACS) therapy on the risk for cystic periventricular leukomalacia (c‐PVL) in very low birth weight (VLBW), very preterm infants, whilst accounting for the occurrence of major neonatal morbidities; sepsis, necrotising enterocolitis, intraventricular haemorrhage and bronchopulmonary dysplasia. Methods Population‐based observational cohort study applying data collected by the Israel national VLBW infant database from 1995–2016. Results Cystic PVL was diagnosed in 692 (6.8%) of the 10,170 study infants. Among 7522 infants exposed to ACS, the rate of c‐PVL was 5.4%, compared to 10.7% among those not exposed ( p < 0.0001). ACS was associated with significantly lower odds for c‐PVL (Odds Ratio [OR] 0.69, 95% confidence interval [CI] 0.57–0.84). In subgroup analyses, excluding infants with one or more morbidities the rates of c‐PVL ranged from 2.7% to 5.4% among infants exposed to ACS compared to 5.6% to 10.7% in those not exposed (all p < 0.0001). ACS was associated with significantly lower OR's for c‐PVL in all subgroups, ranging from 0.52 (95% CI 0.40–0.66) to 0.62 (95% CI 0.50–0.77). Conclusion Infants exposed to ACS had a significantly lower risk of c‐PVL. Subgroup analyses excluding infants with major neonatal comorbidities showed a consistent reduction of 40%–50% in the risk for c‐PVL following ACS therapy.