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Effect of Antenatal and Postnatal Corticosteroid Therapy on Weight Gain and Head Circumference Growth in the Nursery

From Regional Perinatal Center, Sacred Heart Women’s Hospital, Pensacola, Florida; Analytic Consultants of Lee’s Summit, Lee’s Summit, Missouri; Pediatrix Medical Group, Sunrise, Florida; and University of Minnesota Medical School, Minneapolis, Minnesota.

Address reprint requests to: J. A. Thorp, MD, 712 Jamestown Drive, Gulf Breeze, FL 32561; E-mail: jathorp{at}bellsouth.net.

OBJECTIVE: To assess the effect of antenatal and postnatal corticosteroids on head circumference growth and weight gain from birth to discharge.

METHODS: We conducted a retrospective analysis of non-anomalous newborns admitted to the neonatal intensive care unit from 23 to 34 6/7 weeks of gestation. Independent variables included maternal age, race, nulliparity, poor prenatal care, multiple gestation, obstetric complications, alcohol, tocolytic drugs, smoking, illicit drugs, gestational age at birth, presentation, method of delivery, 5-minute Apgar score < 7, surfactant use, severe intracranial hemorrhage, and length of stay.

RESULTS: Antenatal and postnatal corticosteroids were given in 62% and 14% of the newborns, respectively, and 10% of newborns received both. The mean (±SD) weight gain and head circumference growth in the nursery was 440 ± 582 g (n = 14,217) and 2.54 ± 3.42 cm (n = 12,808), respectively. After multivariable analysis, use of antenatal corticosteroids did not affect weight gain (3.6 ± 4.6 g) and head circumference growth (0.05 ± 0.04 cm) compared with no exposure to perinatal corticosteroids, but postnatal corticosteroids were associated with significant reductions in weight gain and head circumference growth (-120 ± 12.2 g and -0.53 ± 0.11 cm, respectively).

CONCLUSIONS: Antenatal corticosteroid therapy did not affect weight gain or head circumference growth in the nursery, even when used in conjunction with postnatal corticosteroid therapy.

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