A Controlled Trial of Hydrocortisone Therapy in Infants With Respiratory Distress Syndrome: II. Pathology

PEDIATRICS ◽  
1973 ◽  
Vol 52 (6) ◽  
pp. 850-854 ◽  
Author(s):  
H. William Taeusch ◽  
Nai San Wang ◽  
Melvin Baden ◽  
Charles R. Bauer ◽  
Leo Stern
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Beneficial Effect ◽  
Intraventricular Hemorrhage ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
Clinical Results ◽  
Steroid Treatment ◽  
Pathological Findings

The pathological findings from seven infants who died with respiratory distress syndrome and had been treated with placebo are compared with seven infants with comparable disease treated with hydrocortisone. Differences in lung, liver, adrenal, thymus, heart and spleen pathology attributable to steroid treatment did not occur between the two groups. A statistically significant association was found between intraventricular hemorrhage and steroid treatment. The pathological findings are consistent with the clinical results in that no beneficial effect occurs when steroids are used after an infant manifests respiratory distress. The possibility that elevated steroid levels increase the likelihood of intraventricular hemorrhage in association with respiratory distress syndrome is raised by these observations, although further information is needed to establish such a relationship.

Physical Development and Medical History of Children Who Were Treated Antenatally With Corticosteroids to Prevent Respiratory Distress Syndrome: A 10- to 12-Year Follow-up

PEDIATRICS ◽  
1990 ◽  
Vol 86 (1) ◽  
pp. 65-70 ◽  
Author(s):  
H. Smolders-de Haas ◽  
J. Neuvel ◽  
B. Schmand ◽  
p. E. Treffers ◽  
J. G. Koppe ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Medical History ◽  
Distress Syndrome ◽  
Hospital Admissions ◽  
Controlled Trial ◽  
Ophthalmological Examination ◽  
Double Blind ◽  
History Of

Potential side effects of antenatal administration of corticosteroids to prevent neonatal respiratory distress syndrome were studied in 10- to 12-year-old children whose mothers had participated in a randomized, double-blind, placebo-controlled trial of betamethasone. The children had a general physical examination; parents were interviewed about the medical history of their child with special attention to infectious diseases; growth data were collected; and a developmental neurological examination, an ophthalmological examination, and a lung function test were conducted. In the corticosteroid group significantly more hospital admissions because of infectious diseases during the first years of life were reported. On the other variables no differences between the corticoid and the placebo groups were found.

Psychological Development of Children Who Were Treated Antenatally With Corticosteroids to Prevent Respiratory Distress Syndrome

PEDIATRICS ◽  
1990 ◽  
Vol 86 (1) ◽  
pp. 58-64
Author(s):  
B. Schmand ◽  
J. Neuvel ◽  
H. Smolders-de Haas ◽  
J. Hoeks ◽  
P. E. Treffers ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Motor Development ◽  
Distress Syndrome ◽  
Controlled Trial ◽  
School Achievement ◽  
Social Emotional ◽  
Behavioral Disturbances ◽  
Double Blind ◽  
Neonatal Respiratory Distress

Potential side effects of antenatal administration of corticosteroids to prevent neonatal respiratory distress syndrome were studied in 10- to 12-year-old children whose mothers had participated in a randomized, double-blind, placebo-controlled trial of betamethasone. Aspects of the children's intellectual and motor development, school achievement, and social-emotional functioning were investigated. There were no differences between the corticoid group and the placebo group on these variables, nor were there more children with learning difficulties and behavioral disturbances in either of the groups.

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.

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