{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T23:27:30Z","timestamp":1788305250420,"version":"build-2803163510"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241706-4\"><jats:title>Importance<\/jats:title><jats:p>When preterm delivery is imminent, it remains unclear whether the timing from administration of antenatal betamethasone to birth may reduce mortality and morbidity among extremely preterm infants.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241706-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the association of duration from exposure to first dose of antenatal betamethasone with outcomes among extremely preterm infants.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241706-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study enrolled infants born at 22 0\/7 to 27 6\/7 weeks\u2019 gestation from January 2016 to February 2021 at National Institute of Child Health and Human Development Neonatal Research Network centers. Infants exposed to multiple doses of antenatal betamethasone, infants who did not receive intensive care, and infants with congenital anomalies were excluded. Data were analyzed from October 2021 to December 2024.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241706-7\"><jats:title>Exposure<\/jats:title><jats:p>Time in hours from anenatal betamethasone administration to birth.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241706-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was survival to discharge. Secondary outcomes included survival without major morbidity and composites of individual morbidities and death. The association of time from antenatal betamethasone administration to birth with neonatal survival and morbidity was assessed using generalized linear models, adjusting for gestational age, infant sex, maternal race, education, small for gestational age, mode of delivery, multiple birth, prolonged rupture of membranes, and center of birth.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241706-9\"><jats:title>Results<\/jats:title><jats:p>Of 7464 infants born during the study period, 1806 infants (928 [51.3%] boys) were included in the cohort: 475 with no betamethasone and 1331 with exposure to a single dose of betamethasone within 24 hours before birth. The median (IQR) administration-to-birth interval for infants born after a single dose of betamethasone was 3.8 (1.4-9.5) hours. The administration-to-birth interval was independently associated with survival (adjusted relative risk [aRR] per 1-hour increase, 1.01 [95% CI, 1.00-1.01]; aRR per 6-hour increase, 1.04 [95% CI, 1.01-1.07]) and survival without severe neonatal morbidity (aRR per 1-hour increase, 1.01 [95% CI, 1.01-1.02]; aRR per 6-hour increase, 1.09 [95% CI, 1.04-1.14].<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241706-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, for women at risk of imminent preterm birth, even short duration of exposure to antenatal betamethasone was associated with improved neonatal survival and survival without severe neonatal morbidity.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.61312","type":"journal-article","created":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T16:32:46Z","timestamp":1740155566000},"page":"e2461312","source":"Crossref","is-referenced-by-count":15,"title":["Short Duration of Antenatal Corticosteroid Exposure and Outcomes in Extremely Preterm Infants"],"prefix":"10.1001","volume":"8","author":[{"given":"Sanjay","family":"Chawla","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Central Michigan University, Wayne State University, Children\u2019s Hospital of Michigan, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myra H.","family":"Wyckoff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satyan","family":"Lakshminrusimha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, UC Davis Children\u2019s Hospital, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew A.","family":"Rysavy","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi Mangal","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine and Children\u2019s Healthcare of Atlanta, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhuly","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"RTI International, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhik","family":"Das","sequence":"additional","affiliation":[{"name":"Social, Statistical, and Environmental Sciences Unit, RTI International, Rockville, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel G.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Girija","family":"Natarajan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Central Michigan University, Wayne State University, Children\u2019s Hospital of Michigan, Detroit, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seetha","family":"Shankaran","sequence":"additional","affiliation":[{"name":"University of Texas at Austin and Dell Children\u2019s Hospital, Austin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward F.","family":"Bell","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Iowa, Iowa City"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namasivayam","family":"Ambalavanan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Alabama at Birmingham, Birmingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelle 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