Prenatal Corticosteroid Use Improves the Severity and Complications of Necrotizing Enterocolitis in Preterm Infants: A Multicenter Clinical Study in China

Our study is a retrospective multicenter observational cohort study to investigate effect of the use of antenatal corticosteroids (ACS) in preterm infants on the severity of necrotizing enterocolitis (NEC) and its associated complications. We collect clinical data from 443 preterm infants with gestational age(GA) of less than 37 weeks who were diagnosed with NEC in four hospitals across various provinces in China from June 2020 to June 2024. The infants were categorized into an exposed group and a non-exposed group based on whether they received prenatal corticosteroid therapy. 213 preterm infants (48.08%) had received ACS therapy. When compared to the non-exposed group, the severity of NEC in the exposed group demonstrated a statistically significant difference (p=0.005). In the univariate regression analysis, ACS therapy was identified as a significant protective factor against the occurrence of hsPDA (OR=0.612, CI 0.385-0.974), BPD (OR=0.611, CI 0.377-0.989), and the need for surgical intervention (OR=0.609, CI 0.384-0.967). After adjusting for multiple confounding factors, ACS continued to demonstrate its protective effect against the severity of NEC (OR=0.269, CI 0.125-0.581). Therefor , ACS can reduce the severity of NEC and lower the incidence of hsPDA, BPD, and the necessity for surgical in preterm infants.