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Peer-reviewedCC BY-NCActa obstetricia et gynecologica Scandinavica

MRI BRAIN lesions and growth after antenatal steroids in preterm infants: Does timing matter?

  • Mariya Malova1
  • Samuele Caruggi1
  • Flavia Pozzi2
  • Paolo Massirio1
  • Francesco Vinci1
  • Irene Bonato1
  • Andrea Calandrino1
  • Diego Minghetti1
  • Maria Grazia Calevo3
  • Federico Prefumo4
  • Martina Resaz5
  • Dario Paladini6
4 more authors
  • Mariasavina Severino5
  • Domenico Tortora5
  • Andrea Rossi5,7
  • Luca A Ramenghi1,8
8 affiliations
  1. 1Neonatal Intensive Care Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
  2. 2Single-Cycle Master Degree Course in Medicine and Surgery, University of Genoa, Genoa, Italy.
  3. 3Epidemiology and Biostatistics Unit, Scientific Direction, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
  4. 4Obstetrics and Gynecology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
  5. 5Neuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
  6. 6Obstetrics and Gynecology Department, USD Ospedale di Giorno e Patologia Ostetrica - Fetal Medicine and Surgery Program, University of Verona, Verona, Italy.
  7. 7Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
  8. 8Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
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Abstract

Introduction

Antenatal corticosteroids (ACS) are widely used to improve outcomes in preterm infants, with known benefits on respiratory morbidity and intraventricular hemorrhage (IVH). However, the effect of ACS timing on brain injury and development remains unclear. We aimed to evaluate the impact of a complete course of ACS (ccACS), with particular attention to timing, on brain lesions, growth, and neurodevelopment in very low birth weight (VLBW) infants using magnetic resonance imaging (MRI).Material and methods

In this historical cohort study, all VLBW infants admitted to a tertiary neonatal intensive care unit between January 2019 and December 2021 were included. Clinical data, including timing of ACS administration, were collected. The primary outcome was the occurrence of brain injury on MRI at term-equivalent age, including IVH, white matter lesions (WML), and cerebellar hemorrhage (CBH). Secondary outcomes were brain growth and maturation on MRI and neurodevelopment at 2 years assessed using the Griffiths Mental Development Scales. Outcomes were compared between infants with and without ccACS and according to different administration-to-birth intervals.Results

A total of 189 infants were included, of whom 139 (73.5%) received ccACS. Infants exposed to ccACS had a lower incidence of WML (p = 0.02) and moderate/severe IVH (p = 0.04). In extremely preterm infants (<28 weeks), IVH was significantly less frequent when ccACS was administered within 7 days before birth (p = 0.006). No significant differences were observed in brain growth, maturation, or neurodevelopmental outcomes at 2 years.Conclusions

A complete course of ACS was associated with unadjusted lower rates of brain injury in VLBW infants, particularly when administered within 7 days before birth in extremely preterm infants, without adverse effects on brain growth, maturation, or neurodevelopment at 2 years.

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Cite

BibTeXRIS
BibTeX
@article{malova2026brain,
  title = {{MRI BRAIN lesions and growth after antenatal steroids in preterm infants: Does timing matter?}},
  author = {Mariya Malova and Samuele Caruggi and Flavia Pozzi and Paolo Massirio and Francesco Vinci and Irene Bonato and Andrea Calandrino and Diego Minghetti and Maria Grazia Calevo and Federico Prefumo and Martina Resaz and Dario Paladini and Mariasavina Severino and Domenico Tortora and Andrea Rossi and Luca A Ramenghi},
  journal = {Acta obstetricia et gynecologica Scandinavica},
  year = {2026},
  month = oct,
  doi = {10.1111/aogs.70342},
  url = {https://europepmc.org/article/MED/42949830},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - MRI BRAIN lesions and growth after antenatal steroids in preterm infants: Does timing matter?
AU  - Mariya Malova
AU  - Samuele Caruggi
AU  - Flavia Pozzi
AU  - Paolo Massirio
AU  - Francesco Vinci
AU  - Irene Bonato
AU  - Andrea Calandrino
AU  - Diego Minghetti
AU  - Maria Grazia Calevo
AU  - Federico Prefumo
AU  - Martina Resaz
AU  - Dario Paladini
AU  - Mariasavina Severino
AU  - Domenico Tortora
AU  - Andrea Rossi
AU  - Luca A Ramenghi
PY  - 2026
DA  - 2026/10/28
JO  - Acta obstetricia et gynecologica Scandinavica
DO  - 10.1111/aogs.70342
UR  - https://europepmc.org/article/MED/42949830
AB  - Introduction  Antenatal corticosteroids (ACS) are widely used to improve outcomes in preterm infants, with known benefits on respiratory morbidity and intraventricular hemorrhage (IVH). However, the effect of ACS timing on brain injury and development remains unclear. We aimed to evaluate the impact of a complete course of ACS (ccACS), with particular attention to timing, on brain lesions, growth, and neurodevelopment in very low birth weight (VLBW) infants using magnetic resonance imaging (MRI).Material and methods  In this historical cohort study, all VLBW infants admitted to a tertiary neonatal intensive care unit between January 2019 and December 2021 were included. Clinical data, including timing of ACS administration, were collected. The primary outcome was the occurrence of brain injury on MRI at term-equivalent age, including IVH, white matter lesions (WML), and cerebellar hemorrhage (CBH). Secondary outcomes were brain growth and maturation on MRI and neurodevelopment at 2 years assessed using the Griffiths Mental Development Scales. Outcomes were compared between infants with and without ccACS and according to different administration-to-birth intervals.Results  A total of 189 infants were included, of whom 139 (73.5%) received ccACS. Infants exposed to ccACS had a lower incidence of WML (p = 0.02) and moderate/severe IVH (p = 0.04). In extremely preterm infants (<28 weeks), IVH was significantly less frequent when ccACS was administered within 7 days before birth (p = 0.006). No significant differences were observed in brain growth, maturation, or neurodevelopmental outcomes at 2 years.Conclusions  A complete course of ACS was associated with unadjusted lower rates of brain injury in VLBW infants, particularly when administered within 7 days before birth in extremely preterm infants, without adverse effects on brain growth, maturation, or neurodevelopment at 2 years.
SN  - 0001-6349
SN  - 1600-0412
ER  -