Antenatal Corticosteroids and Respiratory Distresses Outcome in Preterm Neonates

Document Type : Original Article

Authors

1 Bir El Abd Hospital, North Sini, Egypt

2 Faculty of Medicine, Suez Canal University, Ismailia, Egypt

Abstract

Background: The value of antenatal corticosteroid regimen in lessening respiratory distress risk in preterm neonates has been well known, and accordingly, antenatal corticosteroid therapy was recommended for any pregnant woman likely to deliver between 24 and 34 weeks of gestation. Therefore, this study aimed to assess the association between the administration of antenatal corticosteroids within the ideal interval of one week before birth and the outcomes of preterm neonates.
Methods: This prospective cohort study included 80 preterm neonates admitted to the neonatal intensive care unit with gestational age from 32 to 37 complete weeks at Suez Canal University Hospitals, Ismailia, Egypt. The newborns were then divided into groups A (did not receive antenatal corticosteroids; n=40) and B (received antenatal corticosteroids; n=40).
Results: Severe respiratory distress syndrome was significantly less frequent in group B  (p <0.05) with lower levels of need for oxygen supplementation (p <0.05).
Conclusion: Neonates who received antenatal corticosteroids developed less severe respiratory distress, compared to neonates who did not receive this medication. The results favored the use of antenatal corticosteroids to prevent respiratory distress when administrated within the ideal interval of one week before birth.
 
 

Keywords

References

  1. Blencowe H, Cousens S, Oestergaard MZ, Chou D, Moller AB, Narwal R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet. 2012; 379(9832):2162-72.
  2. Doyle LW, Casalaz D; Victorian Infant Collaborative Study Group. Outcome at 14 years of extremely low birthweight infants: a regional study. Arch Dis Child Fetal Neonatal Ed. 2016; 85(3):F159-64.
  3. Bonanno C, Wapner RJ. Antenatal corticosteroid treatment: what’s happened since Drs Liggins and Howie? Am J Obstet Gynecol. 2016; 200(4):448-57.
  4. Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017; 3(3):CD004454.
  5. Sinclair JC. Meta-analysis of randomized controlled trials of antenatal corticosteroid for the prevention of respiratory distress syndrome: discussion. Am J Obstet Gynecol. 2012; 173(1):335-44.
  6. Gilstrap LC, Christensen R, Clewell WH, D'Alton ME, Davidson EC, Escobedo MB, et al. Effect of corticosteroids for fetal maturation on perinatal outcomes, February 28-March 2, 1994. Am J Obstetr Gynecol. 1995; 173(1):246-52.
  7. Kamath-Rayne BD, DeFranco EA, Marcotte MP. Antenatal steroids for treatment of fetal lung immaturity after 34 weeks of gestation: an evaluation of neonatal outcomes. Obstet Gynecol. 2012; 119(5):909-16.
  8. American College of Obstetricians and Gynecologists; Society for Maternal-Fetal Medicine. Obstetric care consensus No. 6: periviable birth. Obstet Gynecol. 2017; 130(4):e187-99. ‏
  9. Dawson B, Trapp RG. Basic & clinical biostatistics. New York: McGraw-Hill Companies; 2004. P. 206-27.

10. Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972; 50(4):515‐25.

11. Crowther CA, McKinlay CJ, Middleton P, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes. Cochrane Database Syst Rev. 2015; 2015(7):CD003935.

12. Saccone G, Berghella V. Antenatal corticosteroids for maturity of term or near term fetuses: systematic review and meta-analysis of randomized controlled trials. BMJ. 2016; 355:i5044.

13. Khashana A, Saarela T, Rämet M, Hallman
M. Cortisol intermediates and hydrocortisone responsiveness in critical neonatal disease. J Matern Fetal Neonatal Med. 2017; 30(14):1721-5.

14. Khashana A, Ahmed H, Ahmed A, Abdelwahab A, Saarela T, Rämet M, et al. Cortisol precursors in neonates with vasopressor resistant hypotension in relationship to demographic characteristics. J Matern Fetal Neonatal Med. 2017; 31(18):2473-7.

15. Kemp MW, Newnham JP, Challis JG, Jobe AH, Stock SJ. The clinical use of corticosteroids in pregnancy. Hum Reprod Update. 2016; 22(2):240-59.

16. de la Huerga López A, Sendarrubias Alonso M, Jiménez Jiménez AP, Matías Del Pozo V, Álvarez Colomo C, Muñoz Moreno MF. Antenatal corticosteroids and incidence of neonatal respiratory distress after elective caesarean section in late preterm and term neonates. An Pediatr (Barc). 2019; 91(6):371-7.

17. Sotiriadis A, Tsiami A, Papatheodorou S, Baschat AA, Sarafidis K, Makrydimas G. Neurodevelopmental outcome after a single course of antenatal steroids in children born preterm: a systematic review and meta‐analysis. Obstet Gynecol. 2015; 125(6):
1385-96.

18. Makhija NK, Tronnes AA, Dunlap BS. Antenatal corticosteroid timing: accuracy after the introduction of a rescue course protocol. Am J Obstet Gynecol. 2016; 214(1):120.e1-6.

19. Smith GC, Rowitch D, Mol BW. The role of prenatal steroids at 34-36 weeks of gestation. Arch Dis Child Fetal Neonatal Ed. 2017; 102(4):F284-5.

20. Khan KA, Lewis LE. A comparative study to assess outcome in preterm neonates-using antenatal betamethasone versus dexamethasone. Arch Ped Res. 2019; 10003(1):1-8.‏

21. Danesh A, Janghorbani M, Khalatbari S. Effects of antenatal corticosteroids on maternal serum indicators of infection in women at risk for preterm delivery: a randomized trial comparing betame-thasone and dexamethasone. J Res Med Sci. 2012; 17(10):911-7.

22. Chhatrala JJ, Chawada R. Comparative study of dexamethasone and betamethasone for women at risk of preterm birth. Int J Reprod Contracept Obstet Gynecol. 2015; 4(4):1000-3.

23. Khandelwal M, Chang E, Hansen C. Betamethasone dosing interval: 12 or 24 hours apart? A randomized, noninferiority open trial. Am J Obstet Gynecol. 2012; 206(3):201.e1-11.

24. Lee BH, Stoll BJ, McDonald SA, Higgins RD. Adverse neonatal outcomes associated with antenatal dexamethasone versus antenatal betamethasone. Pediatrics. 2006; 117(5):1503-10.‏

25. Gyamfi‐Bannerman C. Antenatal corticosteroids: it's all about timing. BJOG. 2017; 124(10):1575.

26. Khashana A, Ahmed E. Hyperdehydroepiandrosterone in neonates with hypoxic ischemic encephalopathy and circulatory collapse. Pediatr Neonatol. 2017; 58(6):504-8.

27. Khashana A, Ayoub A, Younes S, Abdelrahman A. Ischemia modified albumin in early neonatal sepsis. Infect Dis (Lond). 2016; 48(6):488-9.

28. Baud O, Foix-L'Helias L, Kaminski M, Audibert F, Jarreau PH, Papiernik E, et al. Antenatal glucocorticoid treatment and cystic periventricular leukomalacia in very premature infants. N Engl J Med. 1999; 341(16):1190-6.

Iranian Journal of Neonatology
Volume 12, Issue 2
April 2021
Pages 40-45

Files

Share

How to cite

Statistics