The effect of antenatal corticosteroids for fetal lung maturity in twin gestations

OBJECTIVE: To determine if antenatal corticosteroids given to twin gestations for fetal lung maturity improves perinatal outcome. STUDY DESIGN: We conducted a retrospective cohort study of 71 patients who received one or more doses of betamethasone for fetal lung maturation, and 76 patients who did not. All patients were between 24-34 weeks gestation and delivered between 24 hrs to 7 days after steroid administration. Perinatal outcome of twin pairs were compared in both groups by chi square analysis. The data was also analyzed in a subset of patients delivered at 24 to 32 weeks. RESULTS: There was no significant difference in the two groups in the incidence of RDS, IVH, or NEC. When comparison was made in the subgroup of patients between 24 to 32 weeks, a statistically significant reduction in neonatal death (p = 0.04) was noted in the group receiving antenatal steroids. Steroid No steroid P-value (n = 71) (n = 76) RDS 42% 41% NS IVH 30% 34% NS NEC 6% 7% NS Neonatal Death 8% 12% NS (Delivered between 24 to 32 weeks) (n = 38) (n = 37) RDS 62% 79% NS Neonatal Death 8% 26% 0.04 CONCLUSION: Antenatal corticosteroids in twins was not associated with a reduction in RDS, IVH or NEC. However a decrease in neonatal mortality was found in patients delivered ≤32 weeks.