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Effectiveness of antenatal dexamethasone in reducing respiratory distress syndrome and mortality in preterm neonates:

Wema Kibanga1, Ritah F Mutagonda2, Robert Moshiro3

  • 1School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar Es Salaam, Tanzania. wemaaswile@gmail.com.

BMC Pediatrics
|March 1, 2023
PubMed

Insights

Antenatal corticosteroids (ACS) did not reduce respiratory distress syndrome (RDS) or mortality in preterm infants in Tanzania. Increased gestational age was the only protective factor against preterm neonatal mortality.

Area of Science:

  • Neonatology
  • Obstetrics
  • Public Health

Background:

  • Respiratory distress syndrome (RDS) is a major cause of preterm infant mortality globally.
  • Antenatal corticosteroids (ACS) are used to reduce complications, but evidence from resource-limited settings is scarce.
  • This study assessed ACS effectiveness in reducing RDS and mortality in a low-resource environment.

Purpose of the Study:

  • To evaluate the effectiveness of antenatal corticosteroids (ACS) in reducing respiratory distress syndrome (RDS) and neonatal mortality among preterm neonates in a resource-limited setting.
  • To identify factors associated with RDS and mortality in preterm infants.
  • To provide evidence for clinical practice in similar settings.

Main Methods:

  • A prospective nested case-control study was conducted in Tanzania involving preterm neonates (28-34 weeks gestation).
  • Data were collected on antenatal corticosteroid exposure, RDS, and neonatal mortality.
  • Logistic regression analysis was used to determine the association between ACS and outcomes, controlling for confounding variables.

Main Results:

  • No significant association was found between ACS exposure and reduced RDS occurrence (AOR: 1.65; 95% CI 0.86-3.15).
  • Lower gestational age, low one-minute APGAR scores, and lower birth weight were significantly associated with RDS.
  • Increased gestational age was the only factor significantly associated with a reduction in neonatal mortality (AHR: 0.70; 95% CI: 0.5-0.92).

Conclusions:

  • Antenatal corticosteroids were not associated with reduced RDS or mortality in this resource-limited setting.
  • Gestational age at birth is a critical determinant of survival in preterm neonates.
  • Further research is needed to optimize preterm infant care in low-resource environments.
Abstract

Keywords:
Antenatal dexamethasonePreterm neonatesRespiratory distress syndrome

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