Postnatal respiratory compliance among premature ventilated neonates associated with variable timing and dosing of antenatal steroids

Am J Perinatol. 2014 Dec;31(12):1073-8. doi: 10.1055/s-0034-1371711. Epub 2014 Apr 4.

Abstract

Background: Antenatal steroids (ANSs) improve the respiratory compliance of premature infants. Many premature neonates are born before the administration of a complete course of ANS.

Objective: The objective of this study was to evaluate the respiratory system compliance (Crs) of premature (≤ 32 weeks gestation), intubated neonates in relation to the dose, and timing of ANS administration.

Study design: Neonates (n = 61) were divided into four groups based on the dose and timing of ANS exposure: Group 1: no ANS; Group 2: partial course (one dose of betamethasone); Group 3: complete course (two doses of betamethasone administered within 2 weeks of delivery); and Group 4: remote course (two doses of betamethasone administered > 2 weeks before delivery). Crs was measured by single-breath occlusion technique.

Results: Indexed respiratory compliance ± standard error of the mean (mL/cmH2O/kg) adjusted for gestational ages were 0.359 ± 0.074, 0.366 ± 0.080, 0.625 ± 0.038, and 0.505 ± 0.060 for Groups 1 to 4, respectively. The mean indexed Crs in complete ANS was significantly higher than that of no ANS (0.266 ± 0.085; p = 0.016) as well as partial ANS group (0.259 ± 0.086; p = 0.025).

Conclusions: Crs after birth was significantly higher among premature intubated neonates born to mothers who received a complete course of ANS within 2 weeks, compared with no ANS or a partial course of ANS.

Publication types

  • Observational Study

MeSH terms

  • Betamethasone / administration & dosage*
  • Birth Weight
  • Female
  • Gestational Age
  • Glucocorticoids / administration & dosage*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / physiopathology*
  • Infant, Premature, Diseases / therapy
  • Lung Compliance / drug effects*
  • Male
  • Postnatal Care
  • Premature Birth / drug therapy*
  • Premature Birth / physiopathology
  • Prenatal Care*
  • Prospective Studies
  • Respiration, Artificial
  • Respiratory Distress Syndrome, Newborn / physiopathology*
  • Respiratory Distress Syndrome, Newborn / therapy
  • Severity of Illness Index

Substances

  • Glucocorticoids
  • Betamethasone

Supplementary concepts

  • Respiratory Distress Syndrome In Premature Infants