Plurality-dependent risk of respiratory distress syndrome among very-low-birth-weight infants and antepartum corticosteroid treatment.

Abstract

The purpose of this study was to determine the effect of antenatal corticosteroids on the incidence of respiratory distress syndrome in singleton infants and multiple infants who weigh <1500 g and are delivered at 24 to 32 weeks of gestation. The incidence of respiratory distress syndrome was established in 4754 singleton infants, 2460 twin infants, and 906 triplet infants. The incidence of respiratory distress syndrome ranged from 58.2% among singleton infants who received a complete course of antenatal corticosteroid to 81.5% in triplets without any treatment. Complete treatment significantly reduced the incidence of respiratory distress syndrome, compared with partial or no treatment (odds ratio, 0.2-0.6). The adjusted risk for respiratory distress syndrome among infants who received a complete course of antenatal corticosteroids compared with singleton infants increased with plurality (odds ratio, 1.4 and 1.8 for twins and triplets, respectively). The effect of corticosteroids decreased with increasing plurality. Irrespective of plurality, a complete course of antenatal corticosteroids significantly reduced the incidence of respiratory distress syndrome, whereas partial treatment had the same effect as no treatment.