TO SEE FETAL OUTCOMES IN PRE TERM BIRTH (GESTATIONAL AGE 34 TO 36 WEEK 6 DAYS) WHO DO NOT RECEIVE ANTENATAL CORTICOSTEROIDS

Introduction: Late preterm birth, defined as delivery between 34 weeks and 36 weeks 6 days, is associated with increased neonatal complications. Antenatal corticosteroids (ACS) are known to improve outcomes in preterm births, yet their use in late preterm deliveries remains variable, especially in resource-limited settings. Guidelines, such as the Irish National SOGP Guideline, often do not recommend ACS for this gestational age due to favorable outcomes in well-resourced settings. Objective: To evaluate neonatal outcomes in late preterm births (34–36+6 weeks) without ACS exposure in a resource-limited setting. Materials and Method: This observational study was conducted at a secondary care hospital / Civil Hospital Mirpurkhas in Pakistan from January to June 2024.  A total of 180 women who delivered between 34 and 36+6 weeks without ACS administration were enrolled. Neonatal outcomes within the first 7 days were documented, including respiratory distress, NICU admission, feeding difficulties, and early neonatal death. Results: Infants born before 35 weeks had significantly higher rates of respiratory distress (72.9%), NICU admission (81.3%), and hypoglycemia. Neonatal mortality was 5%, with all deaths occurring before 36 weeks. Conclusion: the absence of ACS in late preterm births correlates with adverse neonatal outcomes, particularly before 35 weeks, supporting targeted ACS use in resource-limited settings despite differing international guidelines. This contrasts with the Irish National SOGP Guideline, which reports favorable outcomes without ACS in well-resourced settings due to neonatal care.