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The window of improved neonatal respiratory compliance after rescue antenatal steroids

Brian K Jordan1, Diane Schilling2, Cindy T McEvoy2

  • 1Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA. jordabr@ohsu.edu.

Journal of Perinatology : Official Journal of the California Perinatal Association
|May 26, 2018
PubMed

Insights

Premature infants delivered within 7 days of rescue antenatal steroids show improved respiratory compliance. This ideal treatment timing enhances lung function in neonates compared to later delivery.

Area of Science:

  • Neonatal Medicine
  • Pulmonology
  • Obstetrics

Background:

  • Antenatal steroid treatment is crucial for fetal lung maturation.
  • Rescue antenatal steroids are administered when initial treatment is insufficient.
  • Optimal timing for delivery after rescue antenatal steroids is debated.

Purpose of the Study:

  • To determine if delivery within 7 days of rescue antenatal steroids improves infant respiratory compliance.
  • To compare respiratory compliance in premature infants based on delivery timing post-treatment.

Main Methods:

  • Secondary analysis of a randomized trial on rescue antenatal steroids.
  • Stratification of infants by delivery interval (≤7 days vs. >7 days) after treatment.
  • Comparison of passive respiratory compliance between "ideal" and "remote" treatment groups.

Main Results:

  • 27 infants delivered within 7 days (ideal) and 22 delivered >7 days (remote) had evaluable respiratory compliance.
  • Ideal treatment group: GA 30.1 weeks, BW 1362g.
  • Remote treatment group: GA 33.8 weeks, BW 2248g.
  • Significantly higher respiratory compliance in the ideal group (1.32 mL/cm H2O/kg) vs. remote group (1.06 mL/cm H2O/kg; p=0.037).

Conclusions:

  • Delivery within 7 days of rescue antenatal steroid treatment is associated with significantly higher respiratory compliance.
  • This finding suggests an optimal window for delivery to maximize respiratory benefits in premature infants.
  • Timing of delivery relative to rescue antenatal steroids impacts neonatal respiratory outcomes.
Abstract

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