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administration to delivery for reducing the incidence of respiratory distress syndrome in preterm twins Jin-Yi Kuk, Jung-Joo An, Moon-Kyung Kim, Hyun-Hwa Cha, Soo-young Oh, Suk-Joo Choi, Cheong-Rae Roh, Jong-Hwa Kim Samsung Medical Center, OBGYN, Seoul, Republic of Korea OBJECTIVE: To investigate the effect of antenatal corticosteroid (ACS) therapy on the incidence of respiratory distress syndrome (RDS) in preterm twins according to the time interval from ACS administration to delivery. STUDY DESIGN: This retrospective study reviewed 468 twin neonates delivered at 24-34 weeks’ gestation from November 1995 to May 2011. Subjects were categorized into four groups according to ACS exposure and the time interval from ACS administration to delivery (ACS-delivery interval); (1) ACS non-exposure group (n 122), (2) ACS-delivery interval of 2 day group (n 166), (3) ACS-delivery interval of 2-7 day group (n 114) and (4) ACS-delivery interval of 7 day group (n 66). Logistic regression analyses were used to examine the association between ACS-delivery interval and the incidence of RDS after adjusting confounding variables including gestational age at delivery, indication for preterm birth, chorionicity, diabetes, hypertension, and birth order. RESULTS: Compared to the ACS non-exposure group, the incidence of RDS in the ACS-delivery interval 2 day group was not significantly different (50.8% vs. 51.8%, odds ratio [OR]: 1.016, 95% confidence interval [CI]: 0.526-1.962, P 0.963), but RDS occurred significantly less frequently when the ACS-delivery interval was 2-7 day (50.8% vs. 33.3%, OR: 0.169, 95% CI: 0.164-0.748, P 0.007). Although twins in the ACS-delivery interval of 7 days group had lower incidence of RDS compared to the non-exposure group, the difference was not statistically significant (50.8% vs. 39.4%, OR 2.032, 95% CI 0.783, 5.276, P 0.145). CONCLUSION: In twin pregnancies, ACS treatment was associated with a decreased risk of RDS only when the ACS-delivery interval was 2-7 day. Therefore, proper timing of ACS administration in twins with a high risk for preterm birth should be considered carefully. |
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