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Normal lung growth following antenatal dexamethasone treatment for respiratory distress syndrome
W Wiebicke1, A Poynter, V Chernick
1Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Canada.
Insights
Antenatal steroid therapy, like dexamethasone, does not adversely affect childhood lung function. This study found no differences in lung volumes or expiratory flows in children exposed to antenatal steroids compared to placebo.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Pharmacology
Background:
- Antenatal steroid therapy is crucial for reducing respiratory distress syndrome (RDS) in premature infants.
- Concerns exist regarding potential long-term pulmonary effects, based on animal studies showing reduced lung growth.
- Previous research had not assessed the impact of antenatal steroids on pulmonary function in later childhood.
Purpose of the Study:
- To investigate the long-term effects of antenatal steroid exposure on pulmonary function in children.
- To determine if antenatal dexamethasone influences lung volumes and expiratory flows in childhood.
Main Methods:
- Pulmonary function was assessed in children over 6 years old using spirometry and helium-dilution.
- Participants were offspring from a randomized trial of antenatal steroid therapy (dexamethasone vs. placebo).
- Evaluated children born between 28-34 weeks gestation, treated 1-7 days before delivery.
Main Results:
- No significant differences in mean height or weight were observed between the dexamethasone and placebo groups.
- Pulmonary function tests revealed no significant differences in lung volumes between the groups.
- Expiratory flow rates were also comparable between children exposed to antenatal dexamethasone and those who received a placebo.
Conclusions:
- Antenatal dexamethasone treatment does not appear to have adverse effects on lung volumes in childhood.
- The findings suggest no negative impact on expiratory flows in children following antenatal steroid exposure.
- This study provides evidence supporting the safety of antenatal steroids for long-term pulmonary health.
Abstract:
Antenatal steroid therapy reduces the incidence of respiratory distress syndrome (RDS) in premature infants. However, animal studies showed a decrease in lung cell number and lower lung weights in fetal rabbits exposed to hydrocortisone. This prompted us to measure flows and lung volumes (by spirometry and helium-dilution method) in children greater than 6 years who were part of a study by the Collaborative Group on Antenatal Steroid Therapy. The effect of antenatal steroids on subsequent pulmonary function had not previously been studied. Of the 158 children originally enrolled before birth, a total of 8 dexamethasone (DEX)- and 11 placebo-treated children were still local residents and fulfilled the criteria of the study (gestational age, 28-34 weeks; DEX/placebo treatment 1-7 days before delivery). Mean heights and weights were normal with no significant differences between the groups. Pulmonary function tests showed no differences in lung volumes or expiratory flows between the children whose mothers had received antenatal DEX and those who had received placebo. These results indicate no adverse effect of antenatal DEX on subsequent lung volumes and expiratory flows in childhood.