Background: Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide, largely due to respiratory and systemic complications of immaturity. Antenatal corticosteroids (ACS) are recommended for women at risk of preterm delivery as they accelerate fetal lung maturation and reduce neonatal complications. However, the effectiveness of ACS in routine clinical settings depends on timing, completeness of dose, and clinical context. This study was conducted to evaluate the association between antenatal corticosteroid administration and neonatal outcomes in preterm deliveries.

Methods: This hospital-based observational analytical study was conducted in a tertiary care teaching hospital and included 100 preterm deliveries (50 in the ACS group and 50 in the non-ACS group). Maternal and neonatal data were collected using a structured proforma. Neonatal outcomes assessed included Apgar scores, respiratory distress syndrome (RDS), NICU admission, mechanical ventilation requirement, and early neonatal mortality. Statistical analysis was performed using chi-square and t-tests, and a p-value <0.05 was considered significant.

Results: The ACS and non-ACS groups were comparable in baseline maternal characteristics. Neonates in the ACS group showed significantly better outcomes, with lower incidence of Apgar score <7 at 5 minutes (12% vs 30%, p=0.02), reduced RDS (24% vs 44%, p=0.03), and decreased NICU admission rates (36% vs 60%, p=0.01). The requirement for mechanical ventilation was also lower in the ACS group (20% vs 40%, p=0.02). Although early neonatal mortality was lower in the ACS group (4% vs 12%), it did not reach statistical significance.

Conclusion: Antenatal corticosteroid administration is associated with improved neonatal outcomes in preterm births, particularly in reducing respiratory morbidity and NICU admissions. Timely and complete administration of corticosteroids should be emphasized in obstetric practice to improve neonatal survival and reduce morbidity.

KEYWORDS: Antenatal Corticosteroids, Preterm Birth, Neonatal Outcomes, Respiratory Distress Syndrome, NICU Admission, Neonatal Morbidity.