Corticosteroids’ Effect on Neonatal Outcomes in Prelabor Rupture of Membranes During Late Preterm [31I]

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 133 Suppl 1; no. 1; p. 103S
• Main Author: Kidd, Jennifer M J
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved 01.05.2019
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000558808.09623.ea

INTRODUCTION:Recent recommendations from SMFM and ACOG now include administration of corticosteroids in the late preterm period to decrease complications of prematurity. This study attempts to understand if prelabor rupture of membranes during this time experience benefits and/or complications from corticosteroids. METHODS:This study was a retrospective IRB approved cohort study from 2015-2017. It included singleton liveborn pregnancies diagnosed with prelabor rupture of membranes from 34-36 weeks that had not received corticosteroids earlier in the pregnancy. The study excluded fetal anomalies, multiple gestations, prior uterine surgery, placenta previa, malpresentation, active genital herpes, and delivery outside the hospital. Chart review of maternal data included medical history, administration of corticosteroids, intrapartum complications, delivery information, and postpartum complications. Infant data included length of stay, neonatal hospital course, and readmission within 1 month after discharge. RESULTS:The administration and completion of corticosteroids course prior to delivery increased during the study. Mode of delivery between groups was not statistically significant. The length of stay for neonates decreased from 6.8 days to 5.1 days in 2017. The occurrence of hyperbilirubinemia and hypoglycemia decreased by half during the/or study period. Neonatal readmission rate was highest in 2015 secondary to cases of hyperbilirubinemia with no readmissions in 2017. CONCLUSION:This study provides support for administration of antenatal corticosteroids with prelabor rupture of membranes in the late preterm period. This study reviews potential secondary outcomes of decrease in length of stay, hyperbilirubinemia, and readmission for this population. These findings have clinical benefits to the neonates and decreased cost to the health system.