Effect of Corticosteroids on Neonates Born to Mothers Positive for COVID-19
Keywords:
COVID-19, corticosteroids, neonates, Apgar score, respiratory distress, antenatal careAbstract
Background: Corticosteroids reduce this overstimulation, which helps balance the immune system responses so that they are effective and do not cause damage to the person themselves. The administration of antenatal corticosteroids is known to enhance fetal lung maturity and reduce neonatal morbidity in preterm births. However, the safety and efficacy of corticosteroid use in COVID-19 positive pregnancies remain uncertain. This study aimed to evaluate neonatal outcomes following maternal corticosteroid administration in COVID-19 positive pregnant women.
Objectives: To assess and compare the clinical and infection-related outcomes of neonates born to COVID-19 positive mothers who received antenatal corticosteroids versus those who did not.
Methods: This prospective observational study included 174 neonates born to RT-PCR confirmed COVID-19 positive pregnant women between August 2021 and October 2023 at Saraswati Medical College and Hospital, Unnao. Among them, 102 neonates were exposed to antenatal corticosteroids (Group A), and 72 were not exposed (Group B). Maternal and neonatal data were collected, including birth weight, Apgar scores, NICU admission, respiratory distress, neonatal infection status, and other clinical outcomes. Statistical analysis was performed using SPSS software version 20, with p < 0.05 considered significant.
Results: Group A (corticosteroid-exposed) neonates had significantly higher Apgar scores at 1 minute (median: 8 vs. 7, p = 0.042) and 5 minutes (median: 9 vs. 8, p = 0.038). Although not statistically significant, respiratory distress (15.6% vs. 25.0%), need for ventilatory support (5.8% vs. 11.1%), and need for resuscitation at birth (7.8% vs. 13.9%) were lower in Group A. No significant differences were found in neonatal SARS-CoV-2 positivity (2.9% vs. 2.8%), NICU admission (27.4% vs. 30.6%), hypoglycemia, sepsis, jaundice, or neonatal mortality (2.0% vs. 4.2%).
Conclusion: Antenatal corticosteroid use in COVID-19 positive pregnant women was associated with improved neonatal Apgar scores and a non-significant trend toward reduced respiratory complications. These findings support the continued use of corticosteroids in indicated cases during COVID-19 infection, with no increased risk of neonatal infection or short-term morbidity
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