Antenatal hormone therapy for fetal lung maturation

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J D Merrill1, R A Ballard

  • 1University of Pennsylvania School of Medicine, Children's Hospital of Philadelphia, USA.

Clinics in Perinatology
|January 19, 1999
PubMed

Insights

Antenatal corticosteroids (CS) accelerate fetal lung maturation, aiding preterm infant respiratory distress syndrome (RDS) prevention. However, postnatal steroid efficacy and optimal antenatal CS courses require further research.

Area of Science:

  • Perinatology
  • Neonatology
  • Pulmonology

Background:

  • Respiratory distress syndrome (RDS) is a significant concern in preterm infants.
  • Antenatal corticosteroids (CS) are established to promote fetal lung maturation.
  • Thyroid hormones also show potential in accelerating fetal lung development.

Purpose of the Study:

  • To review the efficacy of various agents in accelerating fetal lung maturation.
  • To evaluate the role of antenatal corticosteroids and thyroid hormones in preventing RDS.
  • To assess the potential benefits and limitations of current therapeutic strategies.

Main Methods:

  • Review of animal studies on fetal lung maturation agents.
  • Analysis of clinical research on antenatal and postnatal corticosteroid therapy.
  • Evaluation of multicenter trial data on thyrotropin-releasing hormone (TRH) addition.

Main Results:

  • Antenatal corticosteroids (CS) and thyroid hormones accelerate fetal lung maturation in animal models.
  • Antenatal CS combined with postnatal surfactant is the standard for RDS prevention and treatment.
  • Postnatal steroid efficacy and safety are not yet established.
  • Antenatal TRH addition did not improve neonatal outcomes in recent trials.

Conclusions:

  • Antenatal corticosteroids remain crucial for fetal lung maturation and RDS prevention.
  • Further research is needed to determine the efficacy and safety of postnatal steroids.
  • The optimal number of antenatal CS courses for lung maturation is still unclear.
  • Antenatal TRH does not enhance neonatal outcomes when added to existing regimens.

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