Plurality-dependent risk of severe intraventricular hemorrhage among very low birth weight infants and antepartum corticosteroid treatment

Objective: This study was undertaken to compare the effect of antenatal corticosteroid therapy on the risk for severe intraventricular hemorrhage (IVH grade III-IV) in preterm singleton and multiple very low birth weight (VLBW) infants. Study design: The occurrence of severe IVH was recorded in 5022 singleton, 2032 twin, and 582 triplet infants, delivered at 24 to 32 weeks' gestation, registered in the Israeli National VLBW infant database. Antenatal corticosteroid therapy was defined as complete, partial, or none. Results: The incidence of IVH grade III-IV ranged from 6.8% among singletons receiving complete course to 29.3% in triplets without antenatal corticosteroid treatment. Complete treatment significantly reduced the incidence of IVH in all plurality groups. The adjusted risk for IVH among multiple infants who received a complete course compared with singletons was not significantly different, odds ratio (OR) 1.3, 95% CI 1.0-1.7 for twins and OR 1.5, 95% CI 0.9-2.3 for triplets. Conclusion: Complete course of antenatal corticosteroid therapy was independently associated with decreased risk for severe IVH in singleton and in multiple preterm VLBW infants.