300 - Antenatal corticosteroid associated anthropometric increment of very preterm infants in their corrected age 0 to 6 months

Antenatal corticosteroid (ANS) has been recommended to pregnant mothers at risk of preterm labor and enhances the functional maturity of the fetus. ANS is one of the established therapeutic approaches for very preterm infants (VPIs) born at gestational age (GA) < 32 weeks to decrease mortality, severe respiratory distress, and intraventricular hemorrhage. However, ANS has adverse effects on the intrauterine brain and anthropometric growth. ANS may also predispose VPIs to have impaired postnatal somatic development during admission. To date, there is limited research investigating the association between ANS and the arthrometric outcome after term equivalent age.

Objective:

This study aimed to recognize the link between ANS and the growth velocity in body weight and body height of very preterm infants in their first six months of corrected age.

Design/Methods:

The retrospective study was conducted after the approval of IRB. A total of 815 VPIs were enrolled who were admitted to the neonatal intensive care unit of a university hospital from January 2011 to December 2020 in Taiwan.  The antenatal exposures, demographic information, morbidities, and diagnoses at discharge were collected. Monthly anthropometric measurements of body weight and body heights between corrected age (CA) 0 and 6 months from records of clinic visits were gathered and converted z score of World Health Organization. The primary outcomes were the body weight and the height increments between the corrected age (CA) 0 and 6 months. Infants with death, loss follow-up, or anthropometric data available in a single month were excluded. The relationships between repeated measured anthropometric data and ANS were analyzed by multivariate analysis of generalized estimating equations (GEE) with adjustment of clinical covariates.

Results:

A total of 525 VPIs were finally analyzed. The mean GA was 27.2 weeks, and 499 infants ever received antenatal steroid therapy. VPIs with ANS have higher anthropometric trajectories than those without ANS (Figure 1). Univariate GEE analysis showed preterm infants monthly had 0.619 kg in body weight increment (Table 1) and 2.674 cm in body length from corrected age (CA) 0 to 6 months (Table 2). Compared to infants without ANS, infants with ANS had a significantly additional 0.415 kg increment in body weight (p =0.004) (Table 1) and a 1.075 cm increment in body length (p =0.01) (Table 2) in multivariate GEE analysis.

Conclusion(s):

In this study, exposure to antenatal corticosteroids is associated with higher increments in body weight and body length of very preterm infants in their corrected age 0­­-­6 months.