Effects of antenatal and postnatal corticosteroids on the preterm lung
Open Access
- 1 September 1997
- journal article
- review article
- Published by BMJ in Archives of Disease in Childhood: Fetal & Neonatal
- Vol. 77 (2), F147-F150
- https://doi.org/10.1136/fn.77.2.f147
Abstract
It is nearly 25 years since Liggins and Howie first reported the maturational benefits of antenatal corticosteroids given to mothers of preterm infants.1 They reported reduced incidence of respiratory distress syndrome (RDS) in preterm infants delivered to mothers treated with antenatal steroids. Since then, several other studies have reported similar benefits for antenatal corticosteroids. Indeed, Crowley2 has reported a meta-analysis of 15 randomised trials, conducted between 1972 and 1994, which studied the use of antenatal corticosteroids in preterm labour. Overall, the incidence of RDS was halved in infants delivered to mothers who had received antenatal corticosteroids compared with those born to mothers treated with placebo. Secondary analysis clearly showed that when antenatal corticosteroids are given between 24 hours and 7 days before delivery, the odds ratio is 0.35 (95% CI 0.26–0.46). This is reduced to 0.8 (95% CI 0.56–1.15) if antenatal corticosteroids are given at less than 24 hours before delivery, and to 0.63 (95% CI 0.38–1.07) if given more than seven days before delivery. Clearly, antenatal corticosteroids require at least 24 hours to exert their effects.#### Key messages Ante- and postnatal corticosteroids: Clinical trials of postnatal systemic corticosteroids in established chronic lung disease of prematurity (CLD) have been thoroughly reviewed by Ehrenkranz and Mercurio.3 At least nine randomised controlled trials of parenteral or oral dexamethasone have been reported for infants aged 2–6 weeks of postnatal age.4-12 All except two5 10 were devoted exclusively to intubated babies. The UK collaborative trial, one of the largest with 285 babies, covered a wide clinical spectrum of disease.5 The main outcome measures in most …Keywords
This publication has 47 references indexed in Scilit:
- Increased soluble ICAM-1 in tracheal aspirates of infants with bronchopulmonary dysplasiaThe Lancet, 1993
- Dexamethasone therapy for chronic lung disease in ventilator- and oxygen-dependent infants: A controlled trialThe Journal of Pediatrics, 1989
- A Controlled Trial of Dexamethasone in Preterm Infants at High Risk for Bronchopulmonary DysplasiaThe New England Journal of Medicine, 1989
- Regulation of messenger RNAs for the hydrophobic surfactant proteins in human lung.JCI Insight, 1989
- Sequential changes in pulmonary mechanics in the very low birth weight (≤1000 grams) infantThe Journal of Pediatrics, 1988
- Normal lung growth following antenatal dexamethasone treatment for respiratory distress syndromePediatric Pulmonology, 1988
- Postnatal development of rat lung following retarded fetal lung growthPediatric Pulmonology, 1988
- The effects of preterm delivery and mechanical ventilation on human lung growthEarly Human Development, 1987
- Prenatal development of lung antioxidant enzymes in four speciesThe Journal of Pediatrics, 1987
- Dexamethasone stimulation of fetal rat lung antioxidant enzyme activity in parallel with surfactant stimulation.1985