Are newborn outcomes different for term babies who were exposed to antenatal corticosteroids?


      Antenatal corticosteroids improve newborn outcomes for preterm infants. However, predicting which women presenting for threatened preterm labor will have preterm infants is inaccurate, and many women receive antenatal corticosteroids but then go on to deliver at term.


      This study aimed to compare the short-term outcomes of infants born at term to women who received betamethasone for threatened preterm labor with infants who were not exposed to betamethasone in utero.

      Study Design

      We performed a retrospective cohort study of infants born at or after 37 weeks’ gestational age to mothers diagnosed as having threatened preterm labor during pregnancy. The primary neonatal outcomes of interest included transient tachypnea of the newborn, neonatal intensive care unit admission, and small for gestational age and were evaluated for their association with betamethasone exposure while adjusting for covariates using multiple logistic regression.


      Of 5330 women, 1459 women (27.5%) received betamethasone at a mean gestational age of 32.2±3.3 weeks. The mean age of women was 27±5.9 years and the mean gestational age at delivery was 38.9±1.1 weeks. Women receiving betamethasone had higher rates of maternal comorbidities (P<.001 for diabetes mellitus, asthma, and hypertensive disorder) and were more likely to self-identify as White (P=.022). Betamethasone-exposed neonates had increased rates of transient tachypnea of the newborn, neonatal intensive care unit admission, small for gestational age, hyperbilirubinemia, and hypoglycemia (all, P<.05). Controlling for maternal characteristics and gestational age at delivery, betamethasone exposure was not associated with a diagnosis of transient tachypnea of the newborn (adjusted odds ratio, 1.10; 95% confidence interval, 0.80–1.51), although it was associated with more neonatal intensive care unit admissions (adjusted odds ratio, 1.49; 95% confidence interval, 1.19–1.86) and higher odds of the baby being small for gestational age (adjusted odds ratio, 1.78; 95% confidence interval, 1.48–2.14).


      Compared with women evaluated for preterm labor who did not receive betamethasone, women receiving betamethasone had infants with higher rates of neonatal intensive care unit admission and small for gestational age. Although the benefits of betamethasone to infants born preterm are clear, there may be negative impacts for infants delivered at term.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics
        Practice Bulletin No. 171: management of preterm labor.
        Obstet Gynecol. 2016; 128: e155-e164
        • Roberts D.
        • Dalziel S.
        Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.
        Cochrane Database Syst Rev. 2006; CD004454
        • Souza R.T.
        • Galvão R.B.
        • Leite D.F.B.
        • Passini Jr., R.
        • Baker P.
        • Cecatti J.G.
        Use of metabolomics for predicting spontaneous preterm birth in asymptomatic pregnant women: protocol for a systematic review and meta-analysis.
        BMJ Open. 2019; 9e026033
        • Jobe A.H.
        • Goldenburg R.L.
        Antenatal corticosteroids: an assessment of anticipated benefits and potential risks.
        Am J Obstet Gynecol. 2018; 219: 62-74
        • Nixon P.A.
        • Washburn L.K.
        • O’Shea T.M.
        Antenatal steroid exposure and pulmonary outcomes in adolescents born with very low birth weight.
        J Perinatol. 2013; 33: 806-810
        • Bandyopadhyay A.
        • Slaven J.E.
        • Evrard C.
        • Tiller C.
        • Haas D.M.
        • Tepper R.S.
        Antenatal corticosteriods decrease forced vital capacity in infants born fullterm.
        Pediatr Pulmonol. 2020; 55: 2630-2634
        • Duryea E.L.
        • Hawkins J.S.
        • McIntire D.D.
        • Casey B.M.
        • Leveno K.J.
        A revised birth weight reference for the United States.
        Obstet Gynecol. 2014; 124: 16-22
        • Peaceman A.M.
        • Andrews W.W.
        • Thorp J.M.
        • et al.
        Fetal fibronectin as a predictor of preterm birth in patients with symptoms: a multicenter trial.
        Am J Obstet Gynecol. 1997; 177: 13-18
        • Wapner R.J.
        • Sorokin Y.
        • Mele L.
        • et al.
        Long-term outcomes after repeat doses of antenatal corticosteroids.
        N Engl J Med. 2007; 357: 1190-1198
        • Wapner R.J.
        • Sorokin Y.
        • Thom E.A.
        • et al.
        Single versus weekly courses of antenatal corticosteroids: evaluation of safety and efficacy.
        Am J Obstet Gynecol. 2006; 195: 633-642
        • Krispin E.
        • Borovich A.
        • Hochberg A.
        • et al.
        Neonatal outcomes in term pregnancies treated with antenatal corticosteroids for suspected pre-term labor.
        Arch Gynecol Obstet. 2019; 299: 403-409
        • Shibata M.
        • Kaji T.
        • Yonetani N.
        • et al.
        Effect of prolonged hospitalization on fetal growth in threatened preterm labor.
        J Med Invest. 2019; 66: 153-156
        • Manuck T.A.
        Racial and ethnic differences in preterm birth: a complex, multifactorial problem.
        Semin Perinatol. 2017; 41: 511-518
        • Frisbie W.P.
        • Song S.E.
        • Powers D.A.
        • Street J.A.
        The increasing racial disparity in infant mortality: respiratory distress syndrome and other causes.
        Demography. 2004; 41: 773-800
        • Golichowski A.M.
        • McDonald C.J.
        • Tierney W.M.
        • et al.
        Managing perinatal data with the Regenstrief medical record system.
        J Ambul Care Manage. 1992; 15: 40-53
        • McDonald C.J.
        • Overhage J.M.
        • Tierney W.M.
        • et al.
        The Regenstrief Medical Record System: a quarter century experience.
        Int J Med Inform. 1999; 54: 225-253
        • Subedi D.
        • DeBoer M.D.
        • Scharf R.J.
        Developmental trajectories in children with prolonged NICU stays.
        Arch Dis Child. 2017; 102: 29-34
        • Darlow B.A.
        • Horwood L.J.
        • Wynn-Williams M.B.
        • Mogridge N.
        • Austin N.C.
        Admissions of all gestations to a regional neonatal unit versus controls: 2-year outcome.
        J Paediatr Child Health. 2009; 45: 187-193