Antenatal corticosteroid treatment and neonatal outcomes for infants 501 to 1500 gm in the Vermont-Oxford Trials Network

Article Abstract:

Corticosteroids administered before delivery remains an effective therapy in neonatal outcomes, even with the introduction of surfactant therapy, aggressive resuscitation, and better intensive care of very immature infants. Of 8,749 premature infants in the Vermont-Oxford Trials Network Database, only 18.5% received complete antenatal corticosteroid treatment and 7.5% received partial corticosteroid treatment. Infants whose mothers received either complete or partial treatment showed lower risks for neonatal death, respiratory distress syndrome, intraventricular hemorrhage, pneumothorax, and bronchopulmonary dysplasia, but increased risk of necrotizing enterocolitis. Corticosteroids are not widely used among patients who would benefit from them, but clinical guidelines are advising their use.

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Scientific basis and therapeutic regimens for use of antenatal glucocorticoids

Article Abstract:

Prenatal glucocorticoid therapy appears to help the human fetus mature before preterm delivery. Glucocorticoids are a class of corticosteroids that assist the maturation of fetal lungs and other tissues, and reduce disease, such as respiratory distress syndrome, caused by prematurity. They also hasten glycogen synthesis and induce the production of metabolic enzymes. The consensus panel of the National Institutes of Health recommends either betamethasone or dexamethasone be used. They should be administered only to women at risk of premature birth in doses not to exceed recommendations. These drugs should only be re-administered to women in labor seven to ten days after the first treatment.

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Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994

Article Abstract:

Corticosteroids administered before preterm delivery reduces the risk of neonatal respiratory distress syndrome and other diseases, but may adversely affect the mother. Infants benefit from corticosteroid therapy if they are delivered between 24 hours and seven days after administration of corticosteroids. Mothers may risk infection or an immune response to infection. Pulmonary edema (swelling) also has been linked to corticosteroid use, but in combination with other drugs. Any prenatal treatment may be questionable if there is premature rupture of membranes because of the risk of infection.

Prevention, Infants (Premature), Premature infants, Respiratory distress syndrome

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