P2B143: An Experience with Use of Ante-natal Corticosteroid Among Preterm Birth, Maternal and Neonatal Outcome at the Resource Constraints Settings Maiduguri, North-eastern Nigeria

Background: According to the American College of Obstetrics and Gynaecology (ACOG) and American Academy of Pediatrics (AAP), administration of antenatal corticosteroids to the woman who is at risk of imminent preterm delivery is strongly associated with decreased neonatal morbidity and mortality. It enhances lung maturity and surfactant is phospholipid/glycoprotein molecules that is produced by type II pneumocytes in the alveolar sacs from 22 to 28 weeks gestation. Also following preterm birth, there is poor lung fluid absorption that further compound the preterm baby’s smooth transition from intra-uterine life to extra-uterine life.

Methods: Over the ten years, a retrospective review of 425 case notes of women who had preterm birth with complete information were retrieved and analyzed after obtaining ethical clearance from the hospital’s ethics and research committee. The study was conducted in accordance with Helsinki declaration of 2013 as amended.

Results: During the 10 years study period, 21,458 births and of these, 425 deliveries were below 37 completed weeks, and all benefitted from treatment with antenatal corticosteriod. The preterm birth had benefitted from at least 2 doses of dexamethasone at dose of 6 mg 12 hourly apart, with prevalence of (2.3%). before birth. Four hundred and twenty-five out 493 (86.2%) were retrieved and had complete information their case notes, giving a retrieval rate of 86.2%. There was improved APGAR score (≥7 at 1 and 5 minutes) and respiratory distress syndrome, necrotizing enterocolitis were equally low among the babies in whom mothers had at least 2 doses of ACS. Mortality was equally very low (17.8%).

Conclusion: The prevalence of antenatal corticosteroid administration among mothers with preterm birth (2.3%) was very low, which is also mirror images of its use across Nigeria and other LMIC countries. From our review, dexamethasone use among pregnant mothers with preterm birth had proven beneficial effect in improving survival among preterm babies and also reduced incidences of other complications thereby reducing the duration of hospitalization. We are suggesting that there is need to scale up the use of antenatal/prenatal dexamethasone in pregnant women in imminent preterm birth.