Postnatal lung function in preterm lambs: effects of a single exposure to betamethasone and thyroid hormones

Article Abstract:

One injection of betamethasone and thyroxine directly into the fetal lamb appears to improve lung function when the lamb is prematurely delivered 24 to 48 hours later. Betamethasone is a corticosteroid and thyroxine (T4) is a thyroid hormone. Ewes were held in the shearing position, ultrasound was used to image the fetal lamb, and a needle was passed through the uterus to inject its shoulder with either sustained-release betamethasone or betamethasone in combination with T4 or triiodothyronine (T3). The lamb was delivered preterm either 24 or 48 hours later and lung function was evaluated. Betamethasone made lungs almost twice as easy to inflate in both the 24 hour and 48 hour groups. Breathing function was also improved. Maximal lung volume was increased by 80%. T4 augmented the improvement in lung function and doubled maximal lung volume but only after 48 hours. T3 had no beneficial effect.

Usage, Evaluation, Thyroxine, Betamethasone

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Observational evidence for the efficacy of antenatal steroids from randomized studies of surfactant replacement

Article Abstract:

Steroids administered before delivery can avert death and serious disease in neonates who receive lung surfactant replacement therapy after birth, while reducing health care costs. A total of 1,691 neonates at 43 sites in the U.S. and Europe were studied. Only about 10% received a complete course of prenatal steroids and 15% received a partial course. Except for sepsis and necrotizing enterocolitis, steroids significantly improved outcome in other common conditions associated with prematurity, such as intraventricular hemorrhage, and bronchopulmonary dysplasia. It is not understood why steroids would increase the risk of necrotizing enterocolitis because steroids reduce bacteria colonization. Only about 25% of the patients in this high-risk group received steroids, although clinical studies find them to be safe and effective.

Premature birth, Lung surfactant, Synthetic, Synthetic lung surfactants

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Beneficial effects of the combined use of prenatal corticosteroids and postnatal surfactant on preterm infants

Article Abstract:

Treatment with a combination of corticosteroids and lung surfactant may reduce the number of deaths from respiratory distress syndrome among premature infants. Premature infants have an increased risk of death from respiratory distress syndrome as a result of incomplete development of their lungs. Among 1,224 premature infants, 46 were treated prenatally with corticosteroids, 57 were treated prenatally with corticosteroids and postnatally with surfactant, 555 were treated postnatally with surfactant and 566 did not receive any treatment. None of the infants treated with both corticosteroids and surfactant died from respiratory distress syndrome, compared with 7% of the infants treated with corticosteroids alone, 7% of the infants treated with surfactant alone and 20% of the infants who received no treatment.

Pulmonary surfactant, Pulmonary surfactants

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