[Prenatal steroid treatment--a 4-year material]

Area of Science:

• Neonatal Medicine
• Obstetrics
• Pharmacology

Background:

• Prenatal steroids are established treatments to prevent respiratory distress syndrome (RDS) and mortality in preterm infants.
• Historically, treatment was recommended between 28 and 32 weeks of gestation.
• Current recommendations have expanded to cover 24 to 33 weeks of gestation, with few contraindications.

Purpose of the Study:

• To evaluate the impact of prenatal steroid administration on outcomes in preterm infants under 33 weeks gestational age.
• To assess changes in mortality and RDS rates coinciding with updated treatment guidelines and increased surfactant use.

Main Methods:

• Retrospective analysis of infants born before 33 weeks gestational age between 1990-1993.
• Comparison of outcomes (mortality, RDS) between infants who received prenatal steroids and those who did not.
• Correlation of treatment trends with surfactant administration and infant mortality rates.

Main Results:

• Prenatal steroid administration in infants under 33 weeks significantly reduced RDS (61% vs 82%) and mortality (3.6% vs 18%).
• Infant mortality rates decreased from 18% (1990-1991) to 6% (1992-1993), coinciding with increased use of surfactant and prenatal steroids.
• No adverse maternal or infant complications were attributed to prenatal steroid use.

Conclusions:

• Expanded use of prenatal steroids (24-33 weeks) is associated with significant reductions in mortality and RDS in preterm infants.
• The findings support adherence to current guidelines for prenatal steroid administration.
• Increased surfactant use alongside prenatal steroids may contribute synergistically to improved neonatal outcomes.