Gestational age at glucocorticoids administration after premature rupture of membranes and cerebral white matter damage

OBJECTIVE: We investigated whether gestational age at glucocorticoids administration in very preterm premature rupture of membranes (PROM) affects the occurrence of neonatal cerebral white matter damage (WMD). METHODS: In a cohort of singleton neonates born at 24.0-33.6 weeks after PROM who underwent at least one full course of glucocorticoids (n = 130), we compared the gestational age at first and last course of glucocorticoids between those who developed WMD (n = 8) and those who did not (n = 122) after adjusting for gestational age at PROM using logistic regression with P < 0.05 considered significant. RESULTS: Gestational age at first course of glucocorticoids (P = 0.2), at last course of glucocorticoids (P = 0.2) and at delivery (P = 0.2), were not significantly different between those who developed WMD and those who did not. Although latency between PROM and first course of glucocorticoids was protective against WMD (P = 0.02), the significance was lost after controlling for gestational age at PROM, which was significantly lower in cases that developed WMD (P < 0.01). CONCLUSIONS: In very preterm PROM, the beneficial effect of glucocorticoids on occurrence of WMD is not related to gestational age at steroid administration.