Outcomes for Women With Diabetes at Late Preterm Gestation Who Received Antenatal Corticosteroids: A Population-Based Cohort Study.
The use of antenatal corticosteroids appears to be increasing despite limited and conflicting evidence about its efficacy among women with diabetes in pregnancy.
To separately assess the effects of maternal diabetes and the effects of antenatal corticosteroid administration prior to late preterm birth on adverse maternal and neonatal outcomes.
Cohort study of women who gave birth ≥ 35 weeks gestation between September 2016 and March 2021 in two local health districts in New South Wales, Australia. Women were grouped into one of the following: (1) diabetes and received corticosteroids, (2) diabetes and no corticosteroids, (3) no diabetes and received corticosteroids. Modified Poisson regression was used to estimate adjusted relative risks (aRR).
A total of 5 067 women were included (Group 1 = 205, Group 2 = 4 028, Group 3 = 834). Women who received corticosteroids were characterised by higher proportions of hypertension, hospital-based medical antenatal care, multiple births and caesarean section. There were no differences in maternal and neonatal outcomes for women who had diabetes and received corticosteroids compared to those who had diabetes and did not receive corticosteroids. Women with diabetes who received corticosteroids had a higher risk of infants with neonatal hypoglycaemia (aRR 1.61, 95% CI 1.28-2.02) and admission to nursery or intensive care unit (aRR 1.18, 95% CI 1.02-1.38), compared to women without diabetes who received corticosteroids.
There is limited evidence of benefit for the use of antenatal corticosteroids in late preterm gestations, regardless of diabetes status. Further studies are required to identify potential longer-term benefits or harms.
To separately assess the effects of maternal diabetes and the effects of antenatal corticosteroid administration prior to late preterm birth on adverse maternal and neonatal outcomes.
Cohort study of women who gave birth ≥ 35 weeks gestation between September 2016 and March 2021 in two local health districts in New South Wales, Australia. Women were grouped into one of the following: (1) diabetes and received corticosteroids, (2) diabetes and no corticosteroids, (3) no diabetes and received corticosteroids. Modified Poisson regression was used to estimate adjusted relative risks (aRR).
A total of 5 067 women were included (Group 1 = 205, Group 2 = 4 028, Group 3 = 834). Women who received corticosteroids were characterised by higher proportions of hypertension, hospital-based medical antenatal care, multiple births and caesarean section. There were no differences in maternal and neonatal outcomes for women who had diabetes and received corticosteroids compared to those who had diabetes and did not receive corticosteroids. Women with diabetes who received corticosteroids had a higher risk of infants with neonatal hypoglycaemia (aRR 1.61, 95% CI 1.28-2.02) and admission to nursery or intensive care unit (aRR 1.18, 95% CI 1.02-1.38), compared to women without diabetes who received corticosteroids.
There is limited evidence of benefit for the use of antenatal corticosteroids in late preterm gestations, regardless of diabetes status. Further studies are required to identify potential longer-term benefits or harms.
Authors
Ibiebele Ibiebele, Kraljevic Kraljevic, Glastras Glastras, Weir Weir, Randall Randall, Nippita Nippita
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