Maternal ethnicity influences on neonatal respiratory outcomes after antenatal corticosteroid use for anticipated preterm delivery

Abstract

Objective. To explore the influence of maternal ethnicity on neonatal outcomes after antenatal corticosteroid administration.

Methods. A retrospective review of ethnicity, maternal factors, and neonatal birth outcomes was performed for preterm births at a single institution. Cases were limited to women who received antenatal corticosteroids. The impact of ethnicity on specific neonatal respiratory outcomes and mortality was analyzed by bivariate comparisons and by logistic regression analysis.

Results. Complete ethnicity data were obtained for 548 women. Controlling for gestational age at delivery, diabetes, whether the subject completed a course of steroids, and the dosing of the steroids, logistic regression demonstrated that ethnicity was independently associated with respiratory distress syndrome (compared to Caucasians: African-Americans OR 0.49 (95% CI 0.29–0.85); Filipinos OR 0.45 (95% CI 0.21–0.96).

Conclusions. Ethnicity is independently associated with neonatal respiratory outcomes after antenatal corticosteroid use. Perhaps individualized dosing of antenatal corticosteroids is needed to further improve neonatal outcomes.

Keywords:

• Betamethasone
• ethnicity
• preterm birth
• respiratory distress syndrome

Acknowledgements

The authors thank Drs. Daniel T. Shiau, John Richard, Emory A. Fry, and Michael F. McNamara and Cara Olsen [Ref. 7] for the establishment and analysis of the original database. This work was supported by grants: NIH-NICHD K23HD055305 (Haas) and IUPUI Signature Center Grant to PREGMED, The Indiana University Center for Pharmacogenetics and Therapeutics Research in Maternal and Child Health. Reprints not available from authors. The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government. Three authors are military service members. This work was prepared as part of their official duties. Title 17 U.S.C. 105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. 101 defines a United States Government work as a work prepared by a military service member as part of that person's official duties. The Chief, Navy Bureau of Medicine and Surgery, Washington, DC, Clinical Investigation Program sponsored this study (CIP# NMCSD-2009-0033). The data were presented by LT Sischy at the 2009 Armed Forces District Meeting in Honolulu, HI November 2009 as an oral presentation.