Antenatal Steroids and Acute Kidney Injury in Preterm Infants.

ABSTRACT

OBJECTIVE: The aim of this study was to identify the effects of antenatal steroids (ANS) on acute kidney injury (AKI) in very low birth weight (VLBW) preterm infants. STUDY DESIGN: We performed a retrospective cohort study of VLBW infants admitted to a tertiary-care neonatal intensive care unit between January 2016 and June 2019. Infants were divided into no ANS, partial ANS, and complete ANS groups. Serum creatinine (SCr) levels and rates of AKI during the first 2 weeks of life were compared. RESULTS: During the study period, 335 infants met our inclusion criteria. Among no, partial, and complete ANS groups, there were significant differences in rates of stages 2 and 3 AKI (17, 11, and 6%, respectively). Logistic regression analysis revealed that complete ANS course was associated with lower rates of AKI (odds ratio [OR] = 0.41 95% confidence interval [CI] 0.20-0.83) and stages 2 and 3 AKI (OR = 0.205 95% CI 0.075-0.563) compared with no ANS. Infants in complete ANS group had significantly lower SCr at 72 hours of life and at discharge, SCr peak was compared with infants in no ANS group. CONCLUSION: In VLBW infants, complete ANS exposure may be associated with improved renal function and decreased risk for AKI compared with no ANS. KEY POINTS · The effects of antenatal steroid treatment on renal function in preterm infants are not clear.. · A complete course of antenatal steroid decreases the risk for acute kidney injury in preterm infants.. · Infants who are not exposed to antenatal steroids need closer observation of their renal function..