الفهرس 
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Abstract
Summary
P
reterm delivery has increased in frequency especially late preterm delivery which represent nearly 70% of preterm delivery. It is a leading cause of mortality and morbidity. Nowadays, antenatal corticosteroids become standard practice to obstetricians to pregnant women with threatened preterm delivery and recent studies suggest this practice in late preterm delivery.
So, in our work, we evaluated the effect of antenatal corticosteroids on thyroid function in late preterm infants. The present cross-sectional study included 90 late preterm infants admitted in NICU, El-Demerdash hospital, Ain Shams University, within one year and divided to three groups according to exposure to antenatal corticosteroids:
group A exposed to complete course of antenatal steroids within 2-7 days before delivery. Complete course consists of two doses of 12 mg of betamethasone given intramuscularly 24 hours apart and included 30 cases.
group B received one dose of betamethasone and included 30 cases.
group C who was not exposed to antenatal steroids and included 30 cases.
This study included 42 males and 48 females. Serum samples were obtained for free T3, T4, and TSH levels in the first week of life. The study showed that there was significantly higher serum free T4 levels in group A (who were exposed to complete course) compared to group B (partial course) and group C (control group). While, there were no significant differences in serum TSH, free T3 levels between groups.
In this study, analysis of different perinatal and neonatal variant associated with exposure to antenatal steroids and correlation with these results with thyroid function were done.
As regard gravidity and parity, no difference between three groups exposed and non exposed to antenatal corticosteroids. In relation to thyroid hormones, there was a significant association between high TSH level and G1 (P=0.720).
As regard gestational age, there was significant lower gestational age in group A who were exposed to complete course of antenatal steroids when compared with group B or C (p 0.366). No significant correlation was detected between thyroid function and gestational age.
According to mode of delivery, caesarean section (CS) was more frequent than normal vaginal delivery nearly 90%. In relation to doses of corticosteroids CS was higher in group B who were exposed to partial course of ACS. On the other hand there was no significance relation between mode of delivery and thyroid function.
The main causes of preterm delivery were eclampsia and preeclampsia, premature rupture of membrane (PROM), diabetes with or without polyhydramnios, and spontaneous which was the most common cause. In relation to ACS, there was a significant difference in cause of initiation of delivery between groups (in group A, PROM was the main cause, in group B PROM and spontaneous delivery were the main causes and in group C spontaneous delivery was the main cause).
Conclusions
Antenatal corticosteroids can influence thyroid function in late preterm infants as serum T4 was significantly higher in infants exposed to complete course of steroids compared to those who were exposed to partial course or did not receive antenatal corticosteroids.
Recommendations
1. Promotion of the use of antenatal corticosteroids among obstetricians is recommended due to its beneficial effects on preterm infants including normalization of thyroid functions.
2. Further large scale studies are needed to confirm the beneficial effects of antenatal steroids on thyroid functions