Long-Term neurodevelopmental outcome after antenatal corticosteroid in late-preterm twin neonates: nationwide study

In singleton women who are at risk of late preterm delivery, consideration of antenatal corticosteroid is advocated by clinical guidelines to reduce respiratory complications. However, adoption of this practice has not been universal in twin pregnancies at risk for late preterm birth, because of lack of evidences regarding both effectiveness and long-term safety of corticosteroid in this population. In the current study, we evaluated the long-term neurodevelopmental outcome of late-preterm twin neonates after administration of antenatal corticosteroid. This nationwide population-based study included twin neonates who were delivered in late preterm (34∼36+6 weeks) between 2007 and 2010 and were checked for National Health Screening Program for Infants and Children. Group 1 included neonates from mothers who were injected antenatal corticosteroid and group 2 included neonates without antenatal corticosteroid injection. The risk of long-term neurodevelopmental outcome was compared between the two groups of cases. Adverse long-term neurodevelopmental outcome was defined as occurrence of at least one of the followings: autism, cerebral palsy, speech articulation disorder, developmental disorders of scholastic skills, developmental disorder of motor function, and developmental disorder. During the study period, a total of 10,078 neonates were delivered in late preterm and met the inclusion criteria: 2196 neonates in group 1 and 7882 neonates in group 2. In terms of long-term neurodevelopmental outcome, there were no statistically significant difference between the two groups (Figure). The risk of adverse long-term neurodevelopmental outcome was not increased after administration of antenatal corticosteroid at late preterm twin neonates.