Effect of antenatal corticosteroids on morbidity and mortality of preterm singletons and twins

Purpose: To compare the effect of antenatal corticosteroids (ACS) on neonatal outcomes among singleton and twin pregnancies and the impact of completeness and timing of ministration. Materials and methods: Retrospective cohort study involving 951 preterm deliveries (25(+0)-34(+6) weeks), between 2006 and 2015. Neonatal outcomes were evaluated according to completeness of ACS (Complete n = 441; Rescue n = 38; Incomplete n = 175; No ACS n = 98) and timing of therapy related to delivery (Before 7 days n = 260; After 7 days n = 181). Results: On respiratory distress syndrome (RDS), odds ratio (OR) for twins was 0.172, 95% confidence interval (CI) was 0.047; 0.591 and for singletons 0.390 (95% CI 0.214; 0.703) for complete or rescue courses, and 0.280 (95% CI 0.069; 1.066) for twins and 0.906 (95% CI 0.482; 1.698) for singletons for incomplete courses. About the need for mechanical ventilation (MV), twins had an OR of 0.189 (95% CI 0.052; 0.642) and singletons of 0.404 (95% CI 0.222; 0.727) for complete or rescue courses and twins had OR = 0.225 (95% CI 0.053; 0.874) and singletons of 0.404 (95% CI 0.222; 0.727) for incomplete courses. About timing, group After 7 days had OR = 2.00 for RDS (95% CI 1.21; 3.30) and 2.32 (95% CI 1.42; 3.78) for MV. Conclusions: ACS improves neonatal outcomes both in singleton and twins. Delivering 7 days after a complete course decreased neonatal morbidity.