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Rescue Antenatal Steroids Beneficial for Preterm Infants

Rescue dose 14 days after initial dose improves infants' respiratory compliance and oxygen needs

MONDAY, June 21 (HealthDay News) -- If it has been at least 14 days since an initial dose of antenatal steroids, an additional course of rescue antenatal steroids administered to pregnant women at continued risk of premature delivery can improve their infants' postnatal respiratory function, according to research published in the June issue of the American Journal of Obstetrics & Gynecology.

Cindy McEvoy, M.D., of the Oregon Health and Science University in Portland, and colleagues conducted a randomized, double-blinded study of pregnant women at risk of premature delivery who had received an initial antenatal steroid dose at least 14 days prior. Women in the treatment group received an additional dose of rescue antenatal steroids; women in the control group received only placebo. The primary outcomes measured were respiratory compliance (Crs) and functional residual capacity (FRC) in the infants born to these mothers.

The researchers found that infants of mothers in the treatment group had increased Crs compared with infants in the placebo group. There were no significant FRC differences between the two groups of infants. More infants in the placebo group needed at least 30 percent oxygen supplementation than did those in the treatment group (29 versus 13 percent). These benefits were most pronounced in the subgroup of infants delivered at or before 34 weeks of gestation.

"We speculate that the lower Crs in the placebo group in our study may reflect the dissipation of the beneficial effects of antenatal steroids on induction of the surfactant system. FRC was only slightly increased in the rescue antenatal steroids group, although not significantly different, suggesting that the structural changes after a course of antenatal steroids persist longer than the biochemical changes," the authors write.

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