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Antenatal steroids, condition at birth and respiratory morbidity and mortality in very preterm infants
1Department of Neonatal Paediatrics, University of Western Australia, King Edward Memorial Hospital for Women, Perth, Western Australia.
Insights
Antenatal steroid use improves the condition at birth for very preterm infants. This treatment also lessens the risks of respiratory problems and death associated with poor birth condition.
Area of Science:
- Neonatal research
- Perinatal medicine
- Obstetrics
Background:
- Preterm birth (23-32 weeks) poses significant risks to newborns.
- Infant condition at birth is a critical determinant of neonatal outcomes.
- Respiratory morbidity and mortality are major concerns in preterm infants.
Purpose of the Study:
- To identify perinatal factors influencing the condition of very preterm infants at birth.
- To examine the link between poor birth condition and neonatal respiratory issues, including mortality.
Main Methods:
- A convenience sample of 479 infants was drawn from a population inception cohort.
- Analysis focused on perinatal factors and their impact on birth condition.
- Neonatal respiratory morbidity and mortality were assessed in relation to birth condition.
Main Results:
- Antenatal steroid use significantly reduced the risk of poor acid-base status and low Apgar scores at birth.
- Gestational age correlated with Apgar scores but not cord arterial acid-base status.
- Poor birth condition was linked to increased hyaline membrane disease and mortality, with steroids mitigating these effects.
Conclusions:
- Antenatal steroid administration is associated with improved infant condition at birth.
- Steroid use effectively reduces the adverse respiratory outcomes and mortality linked to poor birth condition in preterm infants.
Aims:
To investigate (1) perinatal factors affecting condition at birth in very preterm infants (23-32 weeks) and (2) the relationship between poor condition at birth and neonatal respiratory morbidity and mortality.
Methodology:
Convenience sample (n = 479) drawn from a geographic population inception cohort.
Results:
Antenatal steroid use reduced the risk of pH < or = 7.20 [Adjusted Odds Ratio 0.29 (95% CI 0.17, 0.50)], one minute Apgar < 4 [0.54 (0.33, 0.88)], and 5 min Apgar < 7 [0.44 (0.23, 0.84)]. Gestational age was significantly related to Apgar score but not cord arterial acid-base status. No other perinatal factor was significant. Poor condition at birth was associated with an increase in the incidence and severity of hyaline membrane disease and death. These effects were lessened in those exposed to steroids.
Conclusion:
Antenatal steroid use is associated with improved condition at birth and reduces the deleterious effects of poor condition at birth on early respiratory morbidity and mortality.