Gestational age at glucocorticoids administration after premature rupture of membranes and cerebral white matter damage

Abstract

Objective. We investigated whether gestational age at glucocorticoids administration in very preterm premature rupture of membranes (PROM) affects the occurrence of neonatal cerebral white matter damage (WMD).

Methods. In a cohort of singleton neonates born at 24.0–33.6 weeks after PROM who underwent at least one full course of glucocorticoids (n = 130), we compared the gestational age at first and last course of glucocorticoids between those who developed WMD (n = 8) and those who did not (n = 122) after adjusting for gestational age at PROM using logistic regression with P < 0.05 considered significant.

Results. Gestational age at first course of glucocorticoids (P = 0.2), at last course of glucocorticoids (P = 0.2) and at delivery (P = 0.2), were not significantly different between those who developed WMD and those who did not. Although latency between PROM and first course of glucocorticoids was protective against WMD (P = 0.02), the significance was lost after controlling for gestational age at PROM, which was significantly lower in cases that developed WMD (P < 0.01).

Conclusions. In very preterm PROM, the beneficial effect of glucocorticoids on occurrence of WMD is not related to gestational age at steroid administration.

Key words:

• Preterm premature rupture of membranes
• antenatal glucocorticoids
• white matter damage
• prematurity

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.