Is antenatal corticosteroids intervention benefit for left-sided
congenital diaphragmatic hernia? --A multicenter retrospectively study
Abstract
Objective To determine the effects of antenatal corticosteroids
treatment for congenital diaphragmatic hernia (CDH). Design A
multicenter retrospectively study Setting Guangzhou Women and Children’s
Medical Center, Guangdong Women and Children Hospital, Third Affiliated
Hospital of Guangzhou Medical College. Methods Antenatal corticosteroids
treatment was administered by intramuscular injection to mothers at 32
weeks of gestation (5mg twice a day for two days) depending of the
clinical course and attending physician. Patients were divided into the
observe group (39 cases) and the control group (40 cases). Main outcome
measures Primary outcome was mortality. Secondary outcome was pulmonary
arterial hypertension (PAH) Results: 79 cases (50 male and 29 females)
were enrolled at 3 center. Of note, there was no significant difference
in prenatal evaluation and the severity of PAH between this two group.
The mortality of this two group was 17.% and 38.5% respectively
(P=0.038). Observe group was associated with a lower
survival(OR=0.3,95% CI=0.1-1.0, P=0.042). After adjusting for potential
confounders, prenatal corticosteroids treatment was associated with a
lower survival (OR=0.7, 95% CI=0.1 to 3.8, p=0.640). Conclusion
Antenatal corticosteroids treatment cannot improve the severity of PAH,
nor improve the mortality. Instead,Antenatal corticosteroids
treatment have been linked to increased mortality. Therefore, Antenatal
corticosteroids treatment cannot be recommended in this data. Funding
This study was supported by Guangdong Basic and Applied Basic Research
Foundation, 2020A1515010296 Key words Congenital diaphragmatic hernia,
prenatal corticosteroids intervention, mortality, pulmonary arterial
hypertension Tweetable abstract Antenatal corticosteroids treatment
seems cannot improve prognosis in patients with CDH.