The Safety and Effectiveness of Corticosteroids in Twin Pregnancy

Abstract

Background: Preterm deliveries are disproportionately caused by multiple pregnancies. All things considered, 10.7% of multiple births occur before 32 weeks and 52.2% before 37 weeks. Prematurity represents the largest cause of global perinatal death. Objective: To evaluate the effectiveness of steroids in twins’ pregnancy between 28 and 36 weeks. Patient and methods: This cross-sectional multi-center research enrolled 150 pregnant women with twin pregnancies at Obstetrics and Gynecology Department, October 6th University Hospital, and Al Galaa Teaching Hospital from June 2022 to February 2023. These patients delivered within 48 hours of receiving antenatal corticosteroids and were followed up for 24 to 72 hours after delivery for the outcome. Results: There was highly significant variation between those who received steroid than those didn’t receive steroid as regard gestational age at birth while there was statistically insignificant difference as regard maternal age, body mass index, gravidity, parity, blood pressure, fetal FL, rate of periventricular leukomalacia (PVL), retinopathy of premature (ROP), birth weight, sex and type of labor. There was statistically significant lower rate of NICU admission, neonatal death, bronchopulmonary dysplasia, respiratory distress syndrome, and intraventricular hemorrhage in those who received steroid than those not received steroid. Conclusion: Antenatal corticosteroids administration is a crucial antenatal intervention in twin early and late preterm deliveries and must be considered especially in developing countries because of lack of facilities. Further studies are required to recognize the efficacy of steroids therapy in twin pregnancies and postnatal long-term effects and to assess in establishing proper guidelines to this unique risk category.