No short-term benefits of antenatal corticosteroid treatment in severely preterm growth restricted fetuses: A case-control study

Background: Antenatal corticosteroid administration to premature, growth restricted fetuses may not be beneficial and even have adverse effects on neonatal outcome. Aims: To determine if preterm growth restricted fetuses benefit from antenatal corticosteroids. Study design: Retrospective cohort study. Methods: All singleton pregnancies with growth restricted fetuses delivered at our department before 34 weeks' gestation or weighing less than 1500 g, between January 2001 and December 2005, were retrospectively reviewed. Neonatal outcome was compared between growth restricted fetuses (defined as abnormal flow patterns in umbilical and middle cerebral arteries) that received antenatal CST (CST group) and those who did not receive antenatal CST (no CST group). The administration of CST appeared to be quasi randomized. Results: A total of 88 pregnancies fulfilled the inclusion criteria (CST group, n = 54; no CST group, n = 34). The incidence of neonatal respiratory distress syndrome in the CST and no CST group was 42% (22/54) and 50% (17/34), respectively (p = 0.44). Neonatal mortality in the CST and no CST group was 9% (5/54) and 12% (4/34), respectively (p = 0.73). The prevalence of adverse neonatal outcome (neonatal mortality, major neonatal morbidity or severe cerebral lesions) in the CST and no CST group was 28% (15/54) versus 24% (8/34), (p = 0.62). Conclusions: Administration of CST to growth restricted preterm fetuses does not appear to be beneficial with respect to short term neonatal outcome.