IMPACT OF ANTENATAL CORTICOSTEROIDS ON FREQUENCY AND MORTALITY DUE TO RESPIRATORY DISTRESS SYNDROME IN PRETERM NEONATES
Abstract
Background: Prematurity is still a major problem for health care services throughout the world. Before the late 1980s, respiratory distress syndrome (RDS) was the primary cause of morbidity and mortality in preterm new-borns. Frequency of RDS and ensuing mortality in infants treated with antenatal steroid is less than those delivered without this therapy. Many pregnant females deliver before term or 37 weeks, hence may be advised this prophylactic therapy without creating significant maternal or foetal side effects. Method: It was a descriptive case-series conducted in the department of obstetrics and gynaecology, unit II of Jinnah Hospital Lahore for a period of 6 months. Results: The study sample of 230 was divided into two groups on the basis of exposure to dexamethasone. RDS was reported 76 (33.0%) cases (preterm neonates) in the study, out of these 26 (22.4%) cases belonged to exposed group and 50 (43.9%) cases belonged to non-exposed group. Mortality due to RDS among all preterm neonates with RDS occurred in total 29 (12.6%) preterm neonates in the study, out of these 5 (4.3%) cases belonged to exposed group and 24 (21.1%) belonged to non-exposed group. Conclusion: Frequency of RDS and mortality due to this disease in group of infants treated with antenatal steroid is far less than the group of preterm new-borns delivered without this therapy.Keywords: Antenatal dexamethasone; effectiveness period; preterm new-borns; RDS; neonatal outcomeReferences
Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. Lancet 2008;371(9606):75–84.
Grqic O, Matijevic R. Dilemmaas about the Antenatal use of corticosteroids for prevention of neonatal morbidity and mortality. Acta Med Croatica 2005;59(2):129–35.
Bonanno C, Wapner RJ. Antenatal corticosteroid treatment: What’s happened since Drs Liggins and Howie? Am J Obstet Gynecol 2009;200(4):448–57.
Crowley P. Prophylactic corticosteroids for preterm delivery (Cochrane Review). Cochrane Libr 1999;1.
Antenatal corticosteroids to reduce to reduce neonatal morbidity and mortality. Green-top guideline No. 7, October 2010; p: 3,4.
Bonanno C, Wapner RJ. Antenatal Corticosteroids in the Management of Preterm Birth: Are we back where we started? Obstet Gynecol Clin North Am. 2012 March; 39(1):47–63.
Chien LY, Ohlsson A, Seshia MM, Boulton J, Sankaran K, Lee SK. Variations in Antenatal Corticosteroid Therapy: A Persistent Problem Despite 30 Years of Evidence. Obstet Gynaecol 2002;99(3):401–8.
Bennet P. preterm labors. In: Edmonds DK, Dewhurst J, editors. Dewhurst’s textbook of obstetrics & gynaecology. 7th ed. Malden, Mass: Blackwell Pub; 2007. p.177–8.
Whitsett JA, Pryhuber GS, Rice WR, Warner BB, Wert SE. Acute respiratory disorders. In: Avery GB, Fletcher MA, MacDonald MG, editors. Neonatology: Pathophysiology and Management of the Newborn. 4th ed. Philadelphia, PA: JB Lippincott Company; 1994. p.429–52.
Shirazi H, Riaz S, Mahmood RA. Morbidity and Mortality Pattern of Newly Born Babies in a Teaching Hospital. J Rawal Med Coll 2015;19(3):204–8.
Schwartz RM, Luby AM, Scanlon JW, Kellog RJ. Effect of surfactants o morbidity, mortality and resource use in new-born infants weighing 500 to 1500g. New Eng J Med 2009:330(21):1476–80.
Nayeri F, Movaghar-Nezhad K, Assar-Zadegan F. Effects of antenatal steroids on the incidence and severity of respiratory distress syndrome in an Iranian hospital. East Mediterr Health J 2005;11(4):716–22.
Klinger G, Koren G. Controversies in antenatal corticosteroid treatment. Can Fam Physician 2000;46:1571–3.
Effect of corticosteroids for foetal maturation on perinatal outcomes. NIH Consens Statement 1994;12(2):1–24.
Wang K, Chen CY, Chen CP. Effects of Antenatal Corticosteroids in Preterm Delivery. Taiwan J Obstet Gynaecol 2004;43(4):193–8.
Mwansa-Kambafwile J, Cousens S, Hansen T, Lawn JE. Antenatal steroids in preterm labour for the prevention of neonatal deaths due to complications of preterm birth. Int J Epidemiol 2010;39(Suppl 1):i122–33.
Purandare CN. Fetal Lung Maturity. J Obstet Gynecol India 2005;55(3):215–7.
Rauch D, Zieve D, Greene A. Neonatal respiratory distress syndrome. MedlinePlus Medical Encyclopedia [Internet]. [cited 2016 Sep 17]. Available from: https://medlineplus.gov/ency/article/001563.htm
Roberts D, Dalziel S. Antenatal corticosteroids for accelerating foetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2006;3:CD004454.
Merrill JD, Ballard RA. Clinical Use of Antenatal Corticosteroids: Benefits and Risks. Pediatr Rev 2000;1(5):E91–8.
Saeed F, Siddiqui M R. A Literature Review on Multiple Courses of Antenatal Steroids to Prevent Neonatal Respiratory Distress Syndrome. 2011;2(2)WMC001842.
Veit-Sauca B, Boulahtouf H, Mariette JB, Thevenot P, Gremy M, Ledesert B, et al. Regionalization of perinatal care helps to reduce neonatal mortality and morbidity in very preterm infants and requires updated information for caregivers. Arch Pediatr 2008;15(6):1042–8.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
