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[Prenatal dexametasone and periventricular leucomalacia in prematures]
Cindy Viviana Veloz-Serrano1, Ricardo Jorge Hernández-Herrera, Francisco García-Quintanilla
1Departamento de Neonatología, Hospital de Gineco-obstetricia 23, Instituto Mexicano del Seguro Social, Monterrey, Nuevo León, Mexico.
Insights
Antenatal steroids (AS) did not significantly reduce periventricular leukomalacia (PLM) in premature infants. This study found no difference in PLM incidence between infants who received antenatal dexamethasone and those who did not.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Neurology
Background:
- Prematurity affects 5-8% of deliveries, often leading to long-term handicaps.
- Premature infants face a 5-24% risk of developing periventricular leukomalacia (PLM).
- The efficacy of antenatal steroids (AS) in preventing PLM remains debated.
Purpose of the Study:
- To evaluate the effectiveness of antenatal dexamethasone in preventing periventricular leukomalacia (PLM) in premature neonates.
- To compare the incidence of PLM and other neurological complications between neonates exposed and unexposed to antenatal dexamethasone.
Main Methods:
- A study involving 110 premature neonates (<1500g) divided into a control group and a group receiving antenatal dexamethasone.
- Clinical data, outcomes, and respiratory support needs were recorded.
- Transfontanellar ultrasounds were performed at one month of age to assess for PLM.
Main Results:
- PLM incidence was 10.9% in the control group versus 5.4% in the antenatal dexamethasone group (RR=0.5, CI 95% [0.13-1.90]).
- No significant differences were observed in the rates of normal ultrasounds, intraventricular hemorrhage, or severe hydrocephalus between the groups.
- Other clinical variables also showed no significant differences between the groups.
Conclusions:
- Antenatal dexamethasone administration did not significantly alter the incidence of periventricular leukomalacia (PLM) in this cohort of premature infants.
- The study found no significant benefit of antenatal steroids in preventing PLM or other major neurological complications.
- Further research may be needed to clarify the role of antenatal steroids in managing risks associated with prematurity.
Background:
Prematurity is observed in 5-8% of deliveries, and is frequent cause of handicap. Premature have 5-24% risk for developing periventricular leukomalacia (PLM). The use of antenatal steroids (AS) is controversial for preventing PLM.
Methods:
We studied 110 premature neonates < 1500 g, divided in 2 groups: control (group 1, n = 55), and group 2 (n = 55) who received antenatal dexamethasone. We registered clinical data, evolution and use of oxygen or mechanical ventilation. At one month age a transfontanelar ultrasound was done looking specific PLM.
Results:
In group 1, found 6/55 (10.9%) with PLM and 3/55 (5.4%) in group 2, RR = 0.5, CI 95% (0.13-1.90). In group 1: 30/55 (54.54%) the ultrasound was normal; in 16 (29%) had intraventricular haemorrhage, and in 3 cases (5.45%) had severe hydrocephalus. In group 2: 32/55 (58.18%) ultrasound was normal, 16/55 (29%) had intraventricular haemorrhage, 4/55 (7.27%) had severe hydrocephalus. We did not find significant difference between other variables in both groups.
Conclusions:
There was no significant difference in PLM incidence between patients who did or did not received antenatal dexamethasone.
