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Corticosteroid treatment for prevention of prematurity complications
1Faculty of Medicine Department of Obstetrics and Gynecology, Selcuk University, 42080-Akyokus/Konya, Turkiye. celikcet@hotmail.com
Insights
Antenatal corticosteroid treatment effectively prevents respiratory distress syndrome (RDS) and other complications in premature infants. A single dose proved as effective as multiple doses for RDS prevention.
Area of Science:
- Neonatal Medicine
- Obstetrics
- Pharmacology
Background:
- Premature birth (before 37 weeks gestation) carries significant risks for infants.
- Respiratory distress syndrome (RDS) is a common and serious complication of prematurity.
- Antenatal corticosteroids are used to accelerate fetal lung maturation.
Purpose of the Study:
- To evaluate the efficacy of antenatal corticosteroid treatment for preventing RDS and other prematurity complications.
- To compare different dosing regimens of antenatal corticosteroids.
Main Methods:
- A study involving 1006 infants born between 26-36 weeks gestation.
- Infants were divided into four groups based on antenatal betamethasone administration timing and dosage.
- Outcomes assessed included RDS, surfactant therapy need, ventilation duration, intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, sepsis, and mortality.
Main Results:
- A significant reduction in RDS was observed in infants delivered at least 24 hours after the first betamethasone dose compared to other groups (p=0.029).
- This protective effect was also significant in subgroups with hypertensive disorders and premature rupture of membranes (p=0.002, p=0.041).
- No significant difference in RDS rates was found between single-dose and multiple-dose regimens (p>0.05).
Conclusions:
- Antenatal corticosteroids, particularly a single dose regimen, are effective in preventing respiratory distress syndrome.
- Corticosteroid treatment also aids in preventing other complications associated with prematurity.
- Optimal timing of delivery relative to corticosteroid administration may enhance benefits.
Objective:
To investigate of efficiency to corticosteroid treatment for prevention of respiratory distress syndrome and other prematurity complications.
Materials And Methods:
One thousand and six babies born at 26-36(th) gestational age were investigated for following parameters; the development of respiratory distress syndrome, necessity of surfactant therapy, mean duration of daily ventillatory support, rates of Grade III or IV intraventricular hemorrhage, and periventricular leukomalacia, necrotizing enterocolitis, proven neonatal sepsis and neonatal death. Antenatal steroids were administered in the form of two 12-mg intramuscular doses of betamethasone 12 h apart as a total 24 mg in the 24 h and repeat courses of two 12 mg of betamethasone every 7 days after the first dose of the last course if undelivered. Babies were divided into 4 groups based on betamethasone
Treatment:
The first group or control group didn't received treatment; the second group received treatment and delivered within 12 h after first injection; the third group delivered 12-24 h after first injection; and fourth group delivered at least 24 h after first injection. The patients ongoing pregnancy at least 1 week were divided into two groups as a single dose and multiple courses in once a week.
Results:
Significant difference for development of respiratory distress syndrome between fourth group and others was found (p=0.029). There were significant difference for respiratory distress syndrome rate in hypertensive and premature rupture of membranes groups between fourth group and control group (p=0.002, p=0.041). There weren't significant difference for RDS between repeat doses and single dose groups (p>0.05).
Conclusion:
Single dose corticosteroid is an effective treatment for the development of RDS and the prevention of other prematurity complications.