Effects of antenatal dexamethasone for maternal antepartum haemorrhage on term babies

Authors

  • Ka Wai Kong
  • Kwok Yin Leung

DOI:

https://doi.org/10.12809/hkjgom.23.2.341

Keywords:

Apgar score, Dexamethasone, Infant, small for gestational age, Intensive care units, neonatal

Abstract

Objective: This study aims to compare the outcomes of term babies with or without in utero exposure to dexamethasone as a result of maternal antepartum haemorrhage (APH).
Methods: Medical records of women with antepartum haemorrhage who had a singleton livebirth delivered at ≥37 weeks of gestation in the Queen Elizabeth Hospital, Hong Kong, between 1 January 2019 and 31 December 2021 were retrospectively reviewed. Primary outcomes were the small-for-gestational-age (SGA) rate, the neonatal intensive care unit (NICU) admission rate, and low Apgar score at 5 minutes. Secondary outcomes were the Caesarean section rate and the operative vaginal delivery rate.
Results: A total of 898 women were included; 50 (5.6%) of them had completed a course of antenatal dexamethasone. Compared with women without antenatal dexamethasone, women with antenatal dexamethasone were associated with higher rates of gestational diabetes mellitus (22% vs 7.2%, p<0.001), operative vaginal delivery (16% vs 9.8%, p=0.005), earlier gestational week at delivery (38.2 vs 39.2 weeks, p<0.001), and lower neonatal birthweight (3001.4 vs 3149.6 g, p=0.004). In logistic regression analysis, antenatal exposure to dexamethasone was associated with an increased risk of having an operative vaginal delivery (adjusted odds ratio=2.98, p=0.016) and a reduced risk of having an SGA baby for every 1-week increase in pregnancy (adjusted odds ratio=0.69, p=0.002).
Conclusion: Antenatal dexamethasone for women with antepartum haemorrhage was not associated with SGA infants, NICU admission, or low Apgar score but was associated with earlier delivery, lower neonatal birthweight, and a higher rate of operative vaginal delivery. The latter remained significant in logistic regression analysis. More studies are needed to identify any potential effects on term babies exposed to antenatal corticosteroids.

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Published

2023-05-23

How to Cite

1.
Kong KW, Leung KY. Effects of antenatal dexamethasone for maternal antepartum haemorrhage on term babies. Hong Kong J Gynaecol Obstet Midwifery [Internet]. 2023 May 23 [cited 2024 Jul. 13];23(2). Available from: https://hkjgom.org/home/article/view/341

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