Effects of antenatal glucocorticoids on outcomes of very low birth weight multifetal gestations

Objective: The purpose of this study was to test the hypothesis that benefits of antenatal glucocorticoids to reduce death or major morbidities are similar in very low birth weight multiple and singleton infants. Study Design: Infants with birth weight of 401 to 1500 g who were born from May 1991 through December 1999 were evaluated with the use of the National Institute for Child Health and Human Development Neonatal Research Network registry data. The generalized estimating equations approach to multivariable logistic regression was used, with interaction between multifetal gestation and antenatal glucocorticoids as the primary independent variable. Results: Mothers of multiple infants were more likely to receive antenatal glucocorticoids than mothers of singleton infants (66% vs 56%; P< .01). No interaction between multifetal gestation and antenatal glucocorticoids was noted for any study outcomes. The odds of death or major morbidity was decreased by antenatal glucocorticoids, advancing gestational age, increasing birth weight, female gender, and nonwhite race. Conclusion: If exposed to antenatal glucocorticoids, very low birth weight infants of multifetal gestations and very low birth weight singleton infants have similar risks of death or major morbidity. (Am J Obstet Gynecol 2002;187:804-10.)