Impact of Antenatal Corticosteroids on Cord Blood Cortisol and Early Neonatal Glucose Across Gestational Maturity in Preterm Neonates
Prerana S Bharadwaj, Shrikrishna V AcharyaBackground
Antenatal corticosteroids (ACS) improve neonatal outcomes in preterm infants, but their early hormonal and metabolic effects across gestational maturity strata remain incompletely characterized.
Methods
This observational study with early postnatal follow-up included 100 preterm neonates born between 28⁺⁰ and 36⁺⁶ weeks’ gestation and recruited consecutively at a tertiary-care hospital. Cord blood cortisol was measured at birth, and capillary blood glucose at 24, 48, and 72 h postnatally. ACS exposure was categorized as No, Incomplete, or Complete. As distributions were non-normal, univariate analyses used Kruskal–Wallis and Friedman tests. Factorial aligned rank transform (ART) ANOVA and ART repeated-measures ANOVA evaluated main and interaction effects of ACS exposure, gestational maturity, and postnatal time; factorial analyses were restricted to Moderate and Late preterm strata.
Results
Cord blood cortisol differed significantly by ACS exposure (
Conclusion
ACS exposure was associated with lower cord blood cortisol at birth, whereas early postnatal glucose trajectories were primarily governed by gestational maturity and time, supporting gestation-informed early metabolic monitoring in Moderate and Late preterm neonates.