Antenatal Corticosteroid Exposure in Late Preterm Infants: Clinical Considerations in Diabetic Mothers

Objective The objective of this study was to evaluate the association between antenatal corticosteroid (ACS) administration and respiratory and metabolic outcomes among late preterm infants, with a secondary exploratory analysis of infants of diabetic mothers. Methods We performed a retrospective cohort study of 85 neonates born between 33 0/7 and 35 6/7 weeks’ gestation at a county hospital to investigate neonatal outcomes according to ACS exposure. Outcomes included respiratory support requirement, duration to room air, hypoglycemia, and hospital length of stay. Results Among 85 infants, 18 (21%) received no ACS, 24 (28%) received one dose, and 43 (51%) received two doses. ACS exposure was not associated with increased hypoglycemia (p = 0.163) or hospital length of stay (p = 0.647). Among infants requiring respiratory support (n = 30), greater ACS exposure was associated with fewer days to room air (Spearman’s rho = -0.37, p = 0.044). Conclusions In this small retrospective cohort, ACS exposure was associated with shorter time to room air among late preterm infants requiring respiratory support, without increased risk of hypoglycemia. These findings are exploratory and hypothesis generating, particularly for infants of diabetic mothers.