Antepartum Glucocorticoid Treatment for Prevention of the Respiratory Distress Syndrome in Premature Infants

2021 ◽  
pp. 81-85
Author(s):  
Melissa H. Spiel ◽  
John Zupancic
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Hyaline Membrane Disease ◽  
Premature Delivery ◽  
Glucocorticoid Treatment ◽  
Patients At Risk ◽  
Contemporary Context

Two hundred eighty-two patients at risk for premature delivery were included in this controlled trial of betamethasone therapy versus placebo. Of those included, 213 were in spontaneous premature labor. Ethanol or salbutamol infusions were used to delay delivery while steroid or placebo was given. Among those infants born to mothers who received betamethasone, there were no deaths with hyaline membrane disease or intraventricular hemorrhage. Respiratory distress syndrome occurred less often in those who received betamethasone than in controls (9% vs. 25.8%, p = 0.003), but this difference was primarily for those neonates born less than 32 weeks gestation who had been treated for at least 24 hours before delivery. This article reviews this hallmark study and provides contemporary context for its findings.

A Controlled Trial of Antepartum Glucocorticoid Treatment for Prevention of the Respiratory Distress Syndrome in Premature Infants, by G. C. Liggins, MB, PhD, FRCOG, and R. N. Howie, MB, MRACP, Pediatrics, 1972;50:515–525

PEDIATRICS ◽  
1998 ◽  
Vol 102 (Supplement_1) ◽  
pp. 250-252
Author(s):  
Mary Ellen Avery
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Treated Group ◽  
Premature Delivery ◽  
Glucocorticoid Treatment ◽  
Increased Risk

A controlled trial of betamethasone therapy was carried out in 282 mothers in whom premature delivery threatened or was planned before 37 weeks' gestation, in the hope of reducing the incidence of neonatal respiratory distress syndrome by accelerating functional maturation of the fetal lung. A total of 213 mothers were in spontaneous premature labor. When necessary, ethanol or salbutamol infusions were used to delay delivery while steroid or placebo therapy was given. Delay for at least 24 hours was achieved in 77% of the mothers. In these unplanned deliveries, early neonatal mortality was 3.2% in the treated group and 15.0% in the control subjects. There were no deaths with hyaline membrane disease or intraventricular cerebral hemorrhage in infants of mothers who had received betamethasone for at least 24 hours before delivery. The respiratory distress syndrome occurred less often in treated babies (9.0%) than in controls (25.8%), but the difference was confined to babies of <32 weeks' gestation who had been treated for at least 24 hours before delivery (11.8% of the treated babies compared with 69.6% of the control babies). There may be an increased risk of fetal death in pregnancies complicated by severe hypertension–edema–proteinuria syndromes and treated with betamethasone, but no other hazard of steroid therapy was noted. We conclude that this preliminary evidence justifies additional trials, but that additional work is needed before any new routine procedure is established.

A CONTROLLED TRIAL OF ANTEPARTUM GLUCOCORTICOID TREATMENT FOR PREVENTION OF THE RESPIRATORY DISTRESS SYNDROME IN PREMATURE INFANTS

PEDIATRICS ◽  
1972 ◽  
Vol 50 (4) ◽  
pp. 515-525 ◽  
Author(s):  
G. C. Liggins ◽  
R. N. Howie
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Fetal Lung ◽  
Hyaline Membrane Disease ◽  
Treated Group ◽  
Premature Delivery ◽  
Glucocorticoid Treatment ◽  
Increased Risk

A controlled trial of betamethasone therapy was carried out in 282 mothers in whom premature delivery threatened or was planned before 37 weeks' gestation, in the hope of reducing the incidence of neonatal respiratory distress syndrome by accelerating functional maturation of the fetal lung. Two hundred and thirteen mothers were in spontaneous premature labor. When necessary, ethanol or salbutamol infusions were used to delay delivery while steroid or placebo therapy was given. Delay for at least 24 hours was achieved in 77% of the mothers. In these unplanned deliveries, early neonatal mortality was 3.2% in the treated group and 15.0% in the controls (p 0.01). There were no deaths with hyaline membrane disease or intraventricular cerebral hemorrhage in infants of mothers who had received betamethasone for at least 24 hours before delivery. The respiratory distress syndrome occurred less often in treated babies (9.0%) than in controls (25.8%, p 0.003), but the difference was confined to babies of under 32 weeks' gestation who had been treated for at least 24 hours before delivery (11.8% of the treated babies compared with 69.6% of the control babies p. 0.02). There may be an increased risk of fetal death in pregnancies complicated by severe hypertensionedema-proteinuria syndromes and treated with betamethasone, but no other hazard of steroid therapy was noted. We conclude that this preliminary evidence justifies further trials, but that further work is needed before any new routine procedure is established.

scholarly journals Frequency of neonatal complications after premature delivery

2013 ◽  
Vol 3 (1) ◽  
pp. 65-69 ◽  
Author(s):  
Gordana Grgić ◽  
Elvira Brkičević ◽  
Dženita Ljuca ◽  
Edin Ostrvica ◽  
Azur Tulumović
Keyword(s):  
Body Weight ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Intracranial Hemorrhage ◽  
Premature Infants ◽  
Apgar Score ◽  
Distress Syndrome ◽  
Premature Delivery ◽  
Average Body ◽  
Average Body Weight

Introduction: Preterm delivery is the delivery before 37 weeks of gestation are completed. The incidence of preterm birth ranges from 5 to 15%. Aims of the study were to determine the average body weight, Apgar score after one and five minutes, and the frequency of the most common complications in preterminfants.Methods: The study involved a total of 631 newborns, of whom 331 were born prematurely Aims of this study were to (24th-37th gestational weeks-experimental group), while 300 infants were born in time (37-42 weeks of gestation-control group).Results: Average body weight of prematurely born infants was 2382 grams, while the average Apgar score in this group after the fi rst minute was 7.32 and 7.79 after the fifth minute. The incidence of respiratory distress syndrome was 50%, intracranial hemorrhage, 28.1% and 4.8% of sepsis. Respiratory distresssyndrome was more common in infants born before 32 weeks of gestation. Mortality of premature infants is present in 9.1% and is higher than that of infants born at term.Conclusions: Birth body weight and Apgar scores was lower in preterm infants. Respiratory distress syndrome is the most common fetal complication of prematurity. Intracranial hemorrhage is the second most common complication of prematurity. Mortality of premature infants is higher than the mortality of infants born at term birth.

STUDIES ON HYALINE MEMBRANE DISEASE

PEDIATRICS ◽  
1963 ◽  
Vol 32 (1) ◽  
pp. 10-24
Author(s):  
Clara M. Ambrus ◽  
David H. Weintraub ◽  
Donal Dunphy ◽  
John E. Dowd ◽  
John W. Pickren ◽  
...  
Keyword(s):  
Placebo Group ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Plasminogen Activator ◽  
Premature Infants ◽  
Distress Syndrome ◽  
Hyaline Membrane Disease ◽  
Blood Coagulation Factors ◽  
Plasminogen Activator Activity ◽  
Hyaline Membrane

In the serum of normal prematures and premature infants with respiratory distress syndrome, plasminogen was absent. In mature newborns plasminogen levels were low, as compared to adults. In the euglobulin fraction of plasma, plasminogen level was highest in mature newborns, lower in healthy prematures, and lowest in prematures with respiratory distress syndrome. Antiplasmin level was exceptionally high in about a fourth of the premature infants with or without respiratory distress syndrome. Plasminogen activator activity was found more often in the blood of infants with respiratory distress syndrome than in normal infants. This may be due to the liberation of tissue activators as a consequence of hypoxia. Because of the absence of the substrate (plasminogen), this activator level may have no significance. Tissue activator activity was found in the lungs of premature infants whether they died of hyaline membrane disease or from other causes. Forty-five infants with respiratory distress were treated in a therapeutic study. Twelve were treated in a preliminary series and 33 in a randomizd, double-blind investigation. Of the latter, 11 were treated with placebo, and 5 (45%) survived; 8 were treated with streptokinase activated human plasmin and 2 (25%) survived; 14 were treated with urokinase activated human plasmin and 12 (86%) survived. Among the infants who died, no definite hyaline membrane disease was found by histopathologic examination in two of the placebo group, one in the streptokinase-plasmin treated group, and the two who died in the urokinase-plasmin group. No significant side-effects of plasmin therapy were seen. Although considerable fibrinolytic and plasminogen-activator activity was generated in many treated patients, there was no significant fall in blood coagulation factors. Intracerebral hemorrhage, which appears to occur often in patients who die with hyaline membrane disease, was not more frequent in the plasmintreated group than in the placebo group.

scholarly journals The Effect of Antenatal Corticosteroid Therapy to Respiratory Distress Syndrome Event on Preterm Infants in Surabaya

2018 ◽  
Vol 1 (1) ◽  
pp. 40
Author(s):  
Devy Putri Zenita ◽  
Martono Tri Utomo ◽  
Ernawati Darmawan
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Corticosteroid Therapy ◽  
Premature Infants ◽  
Protective Factor ◽  
Distress Syndrome ◽  
Premature Baby ◽  
Premature Delivery ◽  
Antenatal Corticosteroid ◽  
Dose Administration

ABSTARCTIntroductions: One of the most common cause of morbidity and mortality in premature infants is respiratory distress syndrome (RDS). Several studies have shown that a single dose administration of antenatal corticosteroid therapy in women who are at high risk for premature delivery was associated with decreased incidence of RDS. The study aims to determine the effect of antenatal corticosteroid therapy on the incidence of RDS in prematurity in the Department of Child Health Hospital Dr. Soetomo.Methods: Analytic observational case-control design study was used for this research. Samples were taken from the medical records of RDS patients in premature baby and non-RDS with 36 samples in each group.Results: Antenatal corticosteroid therapy has effect in RDS incidence (p = 0.016). While the results of the odds ratio was 0.298 (with 95% CI 0.110 to 0.810), it means that premature infants with antenatal corticosteroid therapy has 0.298 times lower risk than those who were not given antenatal corticosteroid therapy.Conclusion: Antenatal corticosteroid therapy did not provide a direct relathionship to the incidence of respiratory distress syndrome in premature infants, but it a protective factor that can reduce the incidence of RDS in prematurity.

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