Dexamethasone dosage and course effects on respiratory outcomes in preterm twins: retrospective cohort study.

Saifon Chawanpaiboon, Julaporn Pooliam, Monsak Chuchotiros

Abstract read

In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Saifon ChawanpaiboonDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand. saifon.cha@mahidol.ac.th.ORCID 0000-0002-3207-6187

Julaporn PooliamClinical Epidemiological Unit, Office for Research and Development, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.

Monsak ChuchotirosDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand.

Funding

Faculty of Medicine Siriraj Hospital, Mahidol University [IO] R016633008

6 · The paper itself

Abstract

This retrospective cohort study evaluated the effects of complete, incomplete, and multiple courses of antenatal corticosteroids (ACS) on respiratory outcomes in twin preterm infants born between 28 + 0 and 36 + 6 weeks of gestation. A total of 1,115 neonates were analyzed. Primary outcomes included respiratory distress syndrome (RDS) and other adverse respiratory conditions. Infants exposed to more than one course of dexamethasone had higher requirements for CPAP support (aRR 1.400, 95% CI 1.098-1.785; P = 0.007), increased lung atelectasis (aRR 2.456, 95% CI 1.052-5.730; P = 0.038), and elevated rates of transient tachypnea of the newborn (TTNB) (aRR 1.682, 95% CI 1.194-2.368; P = 0.003). Receiving two or three doses was associated with more severe birth asphyxia (aRR 1.881, 95% CI 1.062-3.331; P = 0.030) and intraventricular hemorrhage (IVH) (aRR 2.001, 95% CI 1.150-3.481; P = 0.014). While RDS rates did not significantly differ among groups, monochorionic diamniotic (MCDA) twins who received multiple ACS courses had a higher risk of RDS (aRR 1.854, 95% CI 1.126-3.053; P = 0.015). These findings suggest that incomplete and repeated ACS courses may contribute to adverse respiratory outcomes, particularly in MCDA twins. Optimizing ACS administration is essential to improve neonatal outcomes in twin preterm pregnancies.

Indexed as

DexamethasoneRespiratory Distress Syndrome, NewbornFemaleGestational AgeHumansInfant, NewbornInfant, PrematureMalePregnancyRetrospective StudiesTwinsDexamethasoneAntenatal corticosteroidsApnoeaDCDADexamethasoneDose‒responseIncomplete courseLate pretermMCDAModerate pretermMore than one coursePrematurityPreterm birthRespiratory distress syndromeTransient tachypneaTwinsVery preterm

Identifiers

PMID41398010

DOI10.1038/s41598-025-27608-3

PMCPMC12706051

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.