DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20185152

Effect of single dose and double dose antenatal corticosteroids on respiratory distress syndrome among preterm babies

Shivtej N., Prema R., Apoorva Naidu, Amrutha B. S., Vidhi B. Mehta

Abstract


Background: Respiratory distress syndrome occurs primarily in premature infants. The increased risk of RDS is associated with lower gestational age. The length of gestation is the primary factor that influences the risk of RDS the risk for development of RDS increases with maternal diabetes, multiple births, cesarean delivery, precipitous delivery, asphyxia, cold stress, and a maternal history of previously affected infants. Antenatal corticosteroids (ACS) significantly reduced neonatal morbidity and mortality when administered to women with imminent preterm delivery Antenatal steroids accelerate development of type 1 and type 2 pneumocytes, leading to structural and biochemical changes that improve both lung mechanics (maximal lung volume, compliance) and gas exchange. Induction of type 2 pneumocytes increases surfactant production by inducing production of surfactant proteins and enzymes necessary for phospholipid synthesis. Alveolisation occurs rapidly as a result of the antenatal corticosteroids Antenatal corticosteroid is usually administered for fetal lung maturity and can be expected to induce negative maternal and fetal side-effects hence this study was conducted to know the beneficial effect of single dose antenatal corticosteroids verses double doses antenatal corticosteroids. The Objective of the present study was to observe the effect of single dose and double dose antenatal corticosteroids on respiratory distress syndrome in preterm babies born to less than 37 weeks of gestation admitted under department of pediatrics at Raja Rajeswari medical college Hospital, Kambipura, Bangalore.

Methods: There were 55 babies born to mothers who received single dose of antenatal corticosteroids and delivered at 12hrs before receiving 2nd dose antenatal corticosteroids and 55 babies born to mothers who received double dose of antenatal corticosteroids. Once baby is born, they compared for the requirement of surfactant.

Results: Multiple course of steroids significantly reduced Respiratory distress syndrome.

Conclusions: It was concluded that there was significant reduction in RDS in babies whose mother received complete course of antenatal corticosteroids.


Keywords


Antenatal corticosteroids (ACS), Neonatal morbidity, Respiratory distress syndrome (RDS)

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References


Lawn J, Davidge R, Paul V, Xyland S, Graft Johnson J, Costello A, et al. Born too soon: care for the preterm baby. Reproductive Health 2013;10 (1):S5.

Haram K, Mortensen JHS, Wollen AL. Preterm delivery: an overview. Acta Obstetricia et Gynecolo Scandinavica 2003;82(8):687‐704.

Tommiska V, Heinonen K, Ikonen S, Kero P, Pokela ML, Renlund M et al., (2001) A national short-term follow-Up study of extremely low birth weight infants born in Finland in 1996-1997. Pediat. 2001;107(1):E2.

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

Shankaran S, Fanaroff AA, Wright LL, Stevenson DK, Donovan EF, Ehrenkranz RA et al (2002) Risk factors for early death among extremely low-birth-weight infants. Am J Obstet Gynecol.2002; 186(4):796-802.

Rautava L, Lehtonen L, Peltola M, Korvenranta E, Korvenranta H, Linna M et al., (2007) The effect of birth in secondary- or tertiary-level hospitals in Finland on mortality in very preterm infants: a birth-register study. Pediat. 2007;119(1):e257-63.

Lemons JA, Bauer CR, Oh W, Korones SB, Papile LA, Stoll BJ, et al Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network, January 1995 through December 1996. NICHD Neonatal Research Network. Pediatr. 2001;107(1):e1.

Gumbinas M, Oda M, Huttenlocher P. The effects of corticosteroids on myelination of the developing rat brain. Biol Neonate 1973; 22(5-6):355-66.

Benediktsson R, Lindsay RS, Noble J, Seckl JR, Edwards CR. Glucocorticoid exposure in utero: new model for adult hypertension. Lancet 1993; 341(8841):339-41.

Kim SM, Sung JH, Kuk JY, Cha HH, Choi SJ, Oh SY et al. Short- and long-term neonatal outcomes according to differential exposure to antenatal corticosteroid therapy in preterm births prior to 24 weeks of gestation. PLoS One. 2018;13(6):e0198471.

Guinn DA, Atkinson MW, Sullivan L, Lee M, Macgregor S, Parilla BV, et al. Single vs weekly courses of antenatal corticosteroids for women at risk of preterm delivery:a randomized controlled trial. JAMA. 2001;286(13):1581-87.

McEvoy C, Bowling S, Williamson K, Lozano D, Tolaymat L, Izquierdo L. The effect of a single remote course versus weekly courses of antenatal corticosteroids on functional residual capacity in preterm infants: a randomized trial. Pediatr. 2002;110(2):280-4.

Peltoniemi OM, Kari MA, Tammela O, Lehtonen L, Marttila R, Halmesmaki E, et al. Randomized trial of a single repeat dose of prenatal betamethasone treatment in imminent preterm birth. Pediatrics. 2007;119(2):290.

Gaur K, Ganguly B. Effect of Single Dose Betamethasone Administration in Pregnancy on Maternal and Newborn Parameters. J Clinic Diagnos Res: JCDR. 2017;11(5):FC15-8.