Comparative analysis on the efficacy of antenatal corticosteroids in preterm newborns in a Kazakhstani Tertiary Care Hospital setting

Table 1 Obstetric and gynecological history of mothers of preterm newborns based on the extent of antenatal steroid prophylaxis, n (%)

Parameters	Obstetric and gynecological history of mothers of preterm newborns based on the extent of antenatal steroid prophylaxis				P value
	Complete, n = 71	Absent, n = 49	Incomplete, n = 32	Total, n = 152
Multiple pregnancy					Р = 0.056, α = 0.0167
Yes	12 (57.1)	2 (9.5)	7 (33.3)	21 (100)
No	59 (45.0)	47 (35.9)	25 (19.1)	131 (100)
Abortion					χ² = 3.73, P = 0.155
Yes	30 (52.6)	13 (22.8)	14 (24.6)	57 (100)
No	41 (43.2)	36 (37.9)	18 (18.9)	95 (100)
Intrauterine infections					Р = 0.623, α = 0.0167
Yes	1 (25.0)	3 (75.0)	0 (0.0)	4 (100)
No	70 (47.3)	46 (31.1)	32 (21.6)	148 (100)
IVF					Р = 0.0012, α = 0.0167; Group 1 – Group 2: P = 1.000; Group 1 – Group 3: Р = 1.000; Group 2 – Group 3: Р = 1.000
Yes	2 (66.7)	0 (0.0)	1 (33.3)	3 (100)
No	69 (46.3)	49 (32.9)	31 (20.8)	149 (100)
Gestational hypertension					χ² = 0.906, P = 0.636
Yes	15 (53.6)	7 (25.0)	6 (21.4)	28 (100)
No	56 (45.2)	42 (33.9)	26 (21.0)	124 (100)
Gestational diabetes					Р = 1.0, α = 0.0167
Yes	2 (25.0)	1 (12.5)	5 (62.5)	8 (100)
No	69 (47.9)	48 (33.3)	27 (18.8)	144 (100)
Gestational thrombocytopenia					Р = 0.056, α = 0.0167
Yes	11 (55.0)	2 (10.0)	7 (35.0)	20 (100)
No	60 (45.5)	47 (35.6)	25 (18.9)	132 (100)
Fetal growth restriction					Р = 0.203, α = 0.0167
Yes	3 (27.3)	6 (54.5)	2 (18.2)	11 (100)
No	68 (48.2)	43 (30.5)	30 (21.3)	141 (100)
Preeclampsia					χ² = 4.317, P = 0.115
Yes	17 (51.5)	6 (18.2)	10 (30.3)	33 (100)
No	54 (45.4)	43 (36.1)	22 (18.5)	119 (100)
Eclampsia					Р = 0.408, α = 0.0167
Yes	0 (0.0)	1 (100.0)	0 (0.0)	1 (100)
No	71 (47.0)	48 (31.8)	32 (21.2)	151 (100)
HELLP syndrome					Р = 1.000, α = 0.0167
Yes	0 (0.0)	0 (0.0)	1 (100.0)	1 (100.0)
No	71 (47.0)	49 (32.5)	31 (20.5)	151 (100.0)
Bleeding					Р = 0.484, α = 0.0167
Yes	4 (36.4)	5 (45.5)	2 (18.2)	11 (100)
No	67 (47.5)	44 (31.2)	30 (21.3)	141 (100)
Threatening fetal condition					χ² = 3.014, P = 0.222
Yes	10 (34.5)	10 (34.5)	9 (31.0)	29 (100)
No	61 (49.6)	39 (31.7)	23 (18.7)	123 (100)
Polyhydramnios					Р = 0.647, α = 0.0167
Yes	4 (50.0)	1 (12.5)	3 (37.5)	8 (100)
No	67 (46.5)	48 (33.3)	29 (20.1)	144 (100)
Oligohydramnios					χ² = 0.339, P = 0.844
Yes	19 (47.5)	14 (35.0)	7 (17.5)	40 (100)
No	52 (46.4)	35 (31.3)	25 (22.3)	112 (100)
PPROM					Р = 0.023, α = 0.0167
Yes	4 (28.6)	9 (64.3)	1 (7.1)	14 (100)
No	67 (48.6)	40 (29.0)	31 (22.5)	138 (100)
Atonic period					χ² = 9.304, Р = 0.0095; Group 1 – Group 2: P = 0.006 (α < 0.0167); Group 1 – Group 3: P = 0.426; Group 2 – Group 3: P = 0.380
Yes	39 (59.1)	15 (22.7)	12 (18.2)	66 (100)
No	32 (37.2)	34 (39.5)	20 (23.3)	86 (100)
Uterine scar					Р = 0.019, α = 0.0167
Yes	13 (41.9)	15 (48.4)	3 (9.7)	31 (100)
No	58 (47.9)	34 (28.1)	29 (24.0)	121 (100)
Cesarean section					χ² = 0.658, P = 0.720
Yes	49 (45.0)	36 (33.0)	24 (22.0)	109 (100)
No	22 (51.2)	13 (30.2)	8 (18.6)	43 (100)
Adhesive process					Р = 0.154, α = 0.0167
Yes	3 (100)	0 (0.0)	0 (0.0)	3 (100)
No	68 (45.6)	49 (32.9)	32 (21.5)	149 (100)
Chorioamnionitis					Р = 0.794, α = 0.0167
Yes	5 (55.6)	2 (22.2)	2 (22.2)	9 (100)
No	66 (46.2)	47 (32.9)	30 (21.0)	143 (100)
Bleeding					Р = 0.642, α = 0.0167
Yes	4 (36.4)	5 (45.5)	2 (18.2)	11 (100)
No	67 (47.5)	44 (31.2)	30 (21.3)	141 (100)
Induction with misoprostol					Р = 0.624, α = 0.0167
Yes	7 (58.3)	3 (25.0)	2 (16.7)	12 (100)
No	64 (45.7)	46 (32.9)	30 (21.4)	140 (100)
Recurrent pregnancy loss					0.743
Yes	7 (53.8)	3 (23.1)	3 (23.1)	13 (100)
No	64 (46.0)	46 (33.1)	29 (20.9)	139 (100)

IVF: In vitro fertilization; PPROM: Preterm premature rupture of membranes.

Table 2 Chronic medical conditions of mothers of preterm newborns based on the extent of antenatal steroid prophylaxis, n (%)

Parameters	Chronic medical conditions of mothers of preterm newborns based on the extent of antenatal steroid prophylaxis				P value
	Complete, n = 71	Absent, n = 49	Incomplete, n = 32	Total, n = 152
Anemia					0.146
Yes	59 (50.4)	34 (29.1)	24 (20.5)	117 (100)
No	12 (34.3)	15 (42.9)	8 (22.9)	35 (100)
Chronic pyelonephritis					0.615
Yes	39 (50.6)	23 (29.9)	15 (19.5)	77 (100)
No	32 (42.7)	26 (34.7)	17 (22.7)	75 (100)
Chronic cholecystitis					0.65
Yes	3 (60.0)	0 (0.0)	2 (40.0)	5 (100)
No	68 (46.3)	49 (33.3)	30 (20.4)	147 (100)
Chronic gastritis					0.763
Yes	2 (50,.0)	2 (50.0)	0 (0.0)	4 (100)
No	69 (46.6)	47 (31.8)	32 (21.6)	148 (100)
Chronic glomerulonephritis					0.605
Yes	0 (0.0)	1 (100)	0 (0.0)	1 (100)
No	71 (47.0)	48 (31.8)	32 (21.2)	151 (100)
Chronic pancreatitis					0.467
Yes	1 (100.0)	0 (0.0)	0 (0.0)	1 (100)
No	70 (46.4)	49 (32.5)	32 (21.2)	151 (100)
Thyrotoxic goiter					0.522
Yes	3 (75.0)	0 (0.0)	1 (25.0)	4 (100)
No	68 (45.9)	49 (33.1)	31 (20.9)	148 (100)
Hypothyroidism					1
Yes	1 (50.0)	1 (50.0)	0 (0.0)	2 (100)
No	70 (46.7)	48 (32.0)	32 (21.3)	150 (100)
Viral hepatitis B					1
Yes	0 (0.0)	1 (100.0)	0 (0.0)	1 (100)
No	71 (47.0)	48 (31.8)	32 (21.2)	151 (100)
Viral hepatitis C					1
Yes	1 (50.0)	0 (0.0)	1 (50.0)	2 (100)
No	70 (46.7)	49 (32.7)	31 (20.7)	150 (100)

Table 3 Additional health history of mothers of preterm newborns based on the extent of antenatal steroid prophylaxis, n (%)

Parameters	Additional health history of mothers of preterm newborns based on the extent of antenatal steroid prophylaxis				P value
	Complete, n = 71	Absent, n = 49	Incomplete, n = 32	Total, n = 152
ARVI					0.282
Yes	5 (71.4)	0 (0.0)	2 (28.6)	7 (100)
No	66 (45.5)	49 (33.8)	30 (20.7)	145 (100)
Medical allergy					0.714
Yes	5 (50.0)	4 (40.0)	1 (10.0)	10 (100)
No	66 (46.5)	45 (31.7)	31 (21.8)	142 (100)
Contact dermatitis					0.642
Yes	1 (50.0)	0 (0.0)	1 (50.0)	2 (100)
No	70 (46.7)	49 (32.7)	31 (20.7)	150 (100)
Obesity					0.903
Yes	11 (45.8)	7 (29.2)	6 (25.0)	24 (100)
No	60 (46.9)	42 (32.8)	26 (20.3)	128 (100)
Varicose veins					0.028; α = 0.0167
Yes	15 (71.4)	4 (19.0)	2 (9.5)	21 (100)
No	56 (42.7)	45 (34.4)	30 (22.9)	131 (100)
Myopia					0.759
Yes	3 (42.9)	3 (42.9)	1 (14.3)	7 (100)
No	68 (46.9)	46 (31.7)	31 (21.4)	145 (100)
Retinal angiopathy					0.723
Yes	4 (44.4)	4 (44.4)	1 (11.1)	9 (100)
No	67 (46.9)	45 (31.5)	31 (21.7)	143 (100)

Table 4 The level of asphyxia in preterm newborns based on the extent of antenatal steroid prophylaxis, n (%)

Asphyxia level	Full dose of ASP, n = 71	No ASP, n = 49	Partial dose of ASP, n = 32	Total, n = 152	P value (α = 0.0167)
None	25 (73.5)	6 (17.6)	3 (8.8)	34 (100)	0.002; Group 1 – Group 2: P = 0.003; Group 1 – Group 3: P = 0.001; Group 2 – Group 3: P = 0.42
Moderate	34 (40.0)	30 (35.3)	21 (24.7)	85 (100)
Severe	12 (36.4)	13 (39.4)	8 (24.2)	33 (100)

ASP: Antenatal steroid prophylaxis.

Table 5 Apgar scores at the first and fifth minute in preterm newborns based on the extent of antenatal steroid prophylaxis

Parameter	ACS				P value
	Complete, n = 71	Absent, n = 49	Incomplete, n = 32	Total, n = 152
Apgar score at the 1st minute	5.38 ± 1.84	4.92 ± 1.77	4.81 ± 1.64	5.11 ± 1.78	0.214
Apgar score at the 5th minute	6.55 ± 1.73	5.94 ± 1.74	5.97 ± 1.62	6.23 ± 1.72	0.101

ACS: Antenatal corticosteroids.

Table 6 Neonatal comorbidities in preterm newborns based on the extent of antenatal steroid prophylaxis, n (%)

Parameters	Prevention of fetal RDS				P value
	Complete, n = 71	Absent, n = 49	Incomplete, n = 32	Total, n = 152
Comorbidities
Cerebral ischemia					0.121
Yes	41 (41.0)	37 (37.0)	22 (22.0)	100 (100.0)
No	30 (57.7)	12 (23.1)	10 (19.2)	52 (100.0)
Congenital pneumonia					0.051
Yes	16 (32.7)	19 (38.8)	14 (28.6)	49 (100.0)
No	55 (53.4)	30 (29.1)	18 (17.5)	103 (100.0)
Respiratory failure					0.588
Yes	16 (47.1)	9 (26.5)	9 (26.5)	34 (100.0)
No	55 (46.6)	40 (33.9)	23 (19.5)	118 (100.0)
Cerebral depression					0.829
Yes	16 (51.6)	9 (29.0)	6 (19.4)	31 (100.0)
No	55 (45.5)	40 (33.1)	26 (21.5)	121 (100.0)
Hypoxic-ischemic encephalopathy					0.592
Yes	13 (56.5)	6 (26.1)	4 (17.4)	23 (100.0)
No	58 (45.0)	43 (33.3)	28 (21.7)	129 (100.0)
Bronchopulmonary dysplasia					0.575
Yes	6 (37.5)	7 (43.8)	3 (18.8)	16 (100.0)
No	65 (47.8)	42 (30.9)	29 (21.3)	136 (100.0)
Congenital hydrocephalus					0.347
Yes	0 (0.0)	1 (100)	0 (0.0)	1 (100.0)
No	71 (47.0)	48 (31.8)	32 (21.2)	151 (100.0)
Heart failure					0.951
Yes	7 (50.0)	4 (28.6)	3 (21.4)	14 (100.0)
No	64 (46.4)	45 (32.6)	29 (21.0)	138 (100.0)
Atrial septal defect					0.882
Yes	3 (42.9)	2 (28.6)	2 (28.6)	7 (100.0)
No	68 (46.9)	47 (32.4)	30 (20.7)	145 (100.0)
Patent ductus arteriosus					0.397
Yes	4 (66.7)	2 (33.3)	0 (0.0)	6 (100.0)
No	67 (45.9)	47 (32.2)	32 (21.9)	146 (100.0)
Ventricular septal defect					0.389
Yes	1 (33.3)	2 (66.7)	0 (0.0)	3 (100.0)
No	70 (47.0)	47 (31.5)	32 (21.5)	149 (100.0)
Transient tachypnea in a newborn					0.730
Yes	1 (50.0)	1 (50.0)	0 (0.0)	2 (100.0)
No	70 (46.7)	48 (32.0)	32 (21.3)	150 (100.0)
Neonatal jaundice					0.531
Yes	18 (40.0)	17 (37.8)	10 (22.2)	45 (100.0)
No	53 (49.5)	32 (29.9)	22 (20.6)	107 (100.0)
Necrotizing enterocolitis					0.825
Yes	4 (50.0)	3 (37.5)	1 (12.5)	8 (100.0)
No	67 (46.5)	46 (31.9)	31 (21.5)	144 (100.0)
Сongenital malformations of the gastrointestinal tract					0.481
Yes	1 (50.0)	0 (0.0)	1 (50.0)	2 (100.0)
No	70 (46.7)	49 (32.7)	31 (20.7)	150 (100.0)
Extreme immaturity					0.886
Yes	9 (50.0)	6 (33.3)	3 (16.7)	18 (100.0)
No	62 (46.3)	43 (32.1)	29 (21.6)	134 (100.0)
Massive pulmonary hemorrhage occurred in the perinatal period					0.636
Yes	2 (66.7)	1 (33.3)	0 (0.0)	3 (100.0)
No	69 (46.3)	48 (32.2)	32 (21.5)	149 (100.0)
Gastrointestinal hemorrhage					0.845
Yes	1 (33.3)	1 (33.3)	1 (33.3)	3 (100.0)
No	70 (47.0)	48 (32.2)	31 (20.8)	149 (100.0)
Intraventricular hemorrhage					0.151
Yes	0 (0.0)	0 (0.0)	1 (100.0)	1 (100.0)
No	71 (47.0)	49 (32.5)	31 (20.5)	151 (100.0)
DIC of blood					0.322
Yes	1 (16.7)	3 (50.0)	2 (33.3)	6 (100.0)
No	70 (47.9)	46 (31.5)	30 (20.5)	146 (100.0)
Anemia in premature newborns					0.501
Yes	1 (50.0)	1 (50.0)	0 (0.0)	2 (100.0)
No	70 (46.7)	48 (32.0)	32 (21.3)	150 (100.0)
Periventricular leukomalacia					0.119
Yes	0 (0.0)	2 (100.0)	0 (0.0)	2 (100.0)
No	71 (47.3)	47 (31.3)	32 (21.3)	150 (100.0)
Proliferative retinopathy					0.730
Yes	1 (50.0)	1 (50.0)	0 (0.0)	2 (100.0)
No	70 (46.7)	48 (32.0)	32 (21.3)	150 (100.0)

RDS: Respiratory distress syndrome; DIC: Disseminated intravascular coagulation.