Do antenatal steroids affect placental histopathology?

OBJECTIVE: To assess whether ihne are hislologicalh identifiable effects of antenatal steroid UM- on phuental hislopalhology. STUDY DESIGN: A t onsecutive series 463 consecutive placentas ol singleton non-anomalous liveboin infants deliveied at <32 week gestation included 280 cases receiving antental steroids for promotion of fatel lung maturity. Of these, 38.14%) recived steroids for <48 hours (duration) and 20-17%) received >2 antenatal doses of sieioids (doses). Plaental bistopathology was reviwed and its characteisitcs were correlated with the duration and number if dises if abtenatal steroid exposure correcting for known contounders such as diagnosis ol preerlainpsia, presence ol lahoi. and gestationai age at deliveiy Statislieal analysis utilized Fisher's exact test, one-way ANOVA and multiple logistic regiession. RESULTS: Antenal steroids administration was independently relaied to increased srverity of villous fibrosis (doses p<0.005; duration p<0.001) hypovascalarity (doses p=0.01; duration p<0.001) and stromal minerali zation (doses p= 0.002; duration p = 0.02),while related to decreased severity of villous edems (duration p = 0.01) and villous stromal hemorrhage (doses p = 0.02. duration, p < 0.001). These relationships ueie indepenceut of preseme and severity of acute infalammatory lesions CONCiLUSIONS: Antenaral steroid administeration for fatal lung maturity enliauemenl is associated wiih plact-ntal lesions that typically reflect placement insufficient or dystunction. Ascertainment hiases are unhkely to account for these findings, sinee they wcie independent of clinical factors and exidencr of chorioamnionitis. Placental effects of antenatal steroid administration deserve fuither stiuh.