[Prevention of the neonatal lung immaturity]

The reported incidence of the preterm deliveries in Bulgaria is 7-11% and it has increased in the recent years. The neonatal respiratory distress syndrome (NRDS) is the most frequent pulmonary disease caused by the biological immaturity. It affects 40-50% of the neonates born before 32 weeks of gestation and results in high morbidity and mortality. There is plenty of evidence, proving that the antenatal corticosteroid (CS) administration decreases the incidence of NRDS in preterm infants.

To study the influence of the implicated algorithm for antenatal prophylaxis of NRDS on the neonatal morbidity and mortality in premature infants.

Two groups of preterm neonates were studied. First group included preterm neonates either without or with a single application of CS before delivery. Second group consisted of preterm newborns with completed CS prophylaxis. The applied antenatal corticosteroid treatment included 4 doses of Betamethazon 7 mg i.m. in 12 hour intervals. It was indicated in cases of a preterm labor between 24-32 gestational weeks. The neonatal mortality, the incidence of NRDS and intraventricular hemorrhage (IVH), the neonatal intensive care unit (NICU) stay and treatment were compared between both groups.

The incidence of NRDS, the need of exogenous surfactant treatment, and the incidence of severe IVH (grades II-IV) were significantly lower in the group with completed CS prophylaxis compared to the control group (p < 0.05). The neonatal mortality rate and the duration of NICU stay and treatment were also reduced among infants with antenatal CS.

The antenatal treatment with CS reduces significantly the risk of development of NRDS and IVH 3d-4th degrees and the neonatal mortality rate of the prematurely born infants. It has also important influence on the duration of NICU stay and treatment and decreases the cost of the neonatal intensive treatment.