BACKGROUND Uncertainty exists regarding the ideal interval between the administration of antenatal corticosteroids (ACS) and delivery. The study's objective was to assess the risks of perinatal mortality and respiratory distress syndrome (RDS) among preterm neonates whose mothers gave birth within 48 h of the administration of ACS and those whose mothers gave birth between 48 h and 7 days. METHODS The study design was a secondary analysis of data from an observational prospective chart review study that was carried out in Tanzania in 2020. Preterm infants born to mothers who got at least one dose of ACS between 28 and 34 weeks of pregnancy were included. RESULTS A total of 346 preterm neonates (294 singletons and 52 twins) were exposed to ACS. Compared to infants born 48 h following the first dose of ACS, those exposed to the drug between 48 h and 7 days had significantly decreased rates of perinatal mortality and RDS. Multivariable analysis revealed that infants exposed ACS between 48 h and 7 days prior to delivery had lower risk of perinatal mortality (aRR 0.30, 95% CI 0.14-0.66) and RDS (aRR 0.27, 95% CI 0.14-0.52). CONCLUSION The first dose of ACS given between 48 h and 7 days before delivery was associated with a lower risk of perinatal mortality and RDS than when the first dose was given <48 h before delivery. To improve neonatal outcomes, healthcare providers should consider administering ACS to mothers at the appropriate time.

中文翻译：

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资源匮乏地区的产前皮质类固醇治疗、分娩间隔和围产期死亡率。

背景关于产前皮质类固醇（ACS）的施用和分娩之间的理想间隔存在不确定性。该研究的目的是评估母亲在 ACS 给药后 48 小时内分娩的早产儿以及母亲在 48 小时至 7 天内分娩的早产儿发生围产期死亡率和呼吸窘迫综合征 (RDS) 的风险。方法 该研究设计是对 2020 年在坦桑尼亚进行的一项观察性前瞻性图表回顾研究的数据进行二次分析。包括在怀孕 28 至 34 周期间至少接受一剂 ACS 的母亲所生的早产儿。结果 共有 346 名早产新生儿（294 名单胎和 52 名双胞胎）接受了 ACS 治疗。与首次服用 ACS 后 48 小时出生的婴儿相比，在 48 小时至 7 天之间接触该药物的婴儿的围产期死亡率和 RDS 显着降低。多变量分析显示，在分娩前 48 小时至 7 天之间接触 ACS 的婴儿围产期死亡率（aRR 0.30，95% CI 0.14-0.66）和 RDS（aRR 0.27，95% CI 0.14-0.52）的风险较低。结论 与产前 48 小时内给予第一剂 ACS 相比，在产前 48 小时至 7 天之间给予第一剂 ACS 与围产儿死亡率和 RDS 风险较低相关。为了改善新生儿结局，医疗保健提供者应考虑在适当的时间对母亲进行 ACS。