The influence of prenatal steroid therapy on the occurrence of respiratory disorders and the use of respiratory support in prematurely born infants

Katarzyna Szymoniak, Dominika Stasik, Dorota Ćwiek, Małgorzata Zimny, Regina Powirska-Swęd, Krystyna Czechowska

Abstract


Introduction: Neonatology is a constantly developing branch of medicine. As it has developed, there has been a reduction in mortality rates among prematurely born infants. The main problem faced by premature infants is respiratory disorders. The frequency of neonatal respiratory failure is inversely proportional to the gestational age and the maturity of the gas exchange system.

The aim of this study was to evaluate the effect of steroid therapy in pregnant women on the occurrence of respiratory distress and the need for respiratory support in premature neonates.

Materials and methods: The study covered 100 premature infants born in the Neonatal Intensive Care Unit of Zdroje Specialist Independent Public Health Care Centre in Szczecin. The newborns were divided into research groups, which consisted of newborns with prenatal steroid therapy, and a control group, which consisted of newborns without steroid therapy. The study was retrospective and was carried out based on the analysis of medical records.

Results: Breathing disorders were more frequent in newborns who had received steroid therapy before birth than in children without teroid therapy. Respiratory failure occurred in children who had received both 1 or 2 doses of prenatal steroid therapy. A similar percentage of children, with and without the use of steroid therapy, required mechanical ventilation. Continuous positive airway pressure was applied both in children who had received steroids during pregnancy and those who had not. However, newborns who had received steroids during pregnancy required respiratory support for a shorter time.

Conclusions: 1. Prenatal steroid therapy does not reduce respiratory disorders in prematurely born children. 2. Respiratory support is required more often by newborns without steroid therapy during pregnancy.


Keywords


prenatal steroid therapy; premature infant; respiratory disorders

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References


Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev 2017;3(3):CD004454. doi: 10.1002/14651858.

Mori R, Kusuda S, Fujimura M. Antenatal corticosteroids promote survival of extremely preterm infants born at 22 to 23 weeks of gestation. J Pediatr 2011;159(1):110-14.e1.

Liu SY, Yang HI, Chen CY, Chou HC, Hsieh WS, Tsou KI, et al. The gestational effect of antenatal corticosteroids on respiratory distress syndrome in very low birth weight infants: a population-based study. J Formos Med. Assoc 2020;119(8):1267-73. doi: 10.1016/j.jfma.2019.11.002.

Kim SM, Sung JH, Kuk JY, Cha HH, Choi SJ, Oh SY, et al. Short- and longterm 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. doi: 10.1371/journal.pone.0198471.

Romejko-Wolniewicz E, Teliga-Czajkowska J, Czajkowski K. Antenatal steroids: can we optimize the dose? Curr Opin Obstet Gynecol 2014;26(2):77-82.

Wong D, Abdel-Latif ME, Kent AL. 1219 differences in mortality/morbidity with a complete course of antenatal steroids compared to an incomplete/no course in extremely premature neonates. Arch Dis Child 2012;97(Suppl 2):A348-9.

Asztalos EV, Murphy KE, Willan AR, Matthews SG, Ohlsson A, Saigal S, et. al. Multiple courses of antenatal corticosteroids for preterm birth study: outcomes in children at 5 years of age (MACS-5). JAMA Pediatr 2013;167(12):1102-10.

Vogel JP, Oladapo OT, Pileggi-Castro C, Adejuyigbe EA, Althabe F, Ariff S, et al. Antenatal corticosteroids for women at risk of imminent preterm birth in low-resource countries: the case for equipoise and the need for efficacy trials. BMJ Glob Health 2017;2(3):e000398. doi: 10.1136/bmjgh-2017-000398.

Pilewska-Kozak A, editor. Opieka nad wcześniakiem. Warszawa: Wydawnictwo Lekarskie PZWL; 2009.

Rojas-Reyes MX, Morley CJ, Soll R. Prophylactic versus selective use of surfactant in preventing morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2012;(3):CD000510.

Gien J, Kinsella JP. Pathogenesis and treatment of bronchopulmonary dysplasia. Curr Opin Pediatr 2011;23(3):305-13.

Chawla S, Natarajan G, Chowdhury D, Das A, Walsh M, Bell EF, et al. Neonatal morbidities among moderately preterm infants with and without exposure to antenatal corticosteroids. Am J Perinatol 2018;35(12):1213-21.

Jobe AH, Goldenberg RL. Antenatal corticosteroids: an assessment of anticipated benefits and potential risks. Am J Obstet Gynecol 2018;219(1):62-74.




DOI: https://doi.org/10.21164/pomjlifesci.791

Copyright (c) 2022 Katarzyna Szymoniak, Dominika Stasik, Dorota Ćwiek, Małgorzata Zimny, Regina Powirska-Swęd, Krystyna Czechowska

License URL: https://creativecommons.org/licenses/by-nc-nd/3.0/pl/