Monday, September 26, 2022
Steroid treatment before birth appears to improve survival and reduce complications in extremely preterm infants, according to a study funded by the National Institutes of Health. Antenatal corticosteroid therapy, given to women at risk of preterm birth, causes the fetal lungs to mature and has been shown to improve survival and reduce complications in infants born between 24 and 34 weeks gestation. However, previous studies on the treatment of infants born between the 22n/a and 23rd week – those at greatest risk of death and disability – have been inconclusive.
The study was led by Sanjay Chawla, MD, of Central Michigan University, Mount Pleasant, and Wayne State University, Detroit, and colleagues from 17 US research institutes. He appears in Open JAMA Network. Funding was provided by the NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Center for the Advancement of Translational Sciences.
Of the mothers of the 431 infants in the study, 110 did not receive the steroid betamethasone, 80 received partial treatment (one dose) and 241 received full treatment (two doses 24 hours apart).
Among infants exposed to full treatment, 53.9% survived to hospital discharge, compared to 37.5% with partial treatment and 35.5% without treatment. Compared to infants receiving no treatment, infants exposed to full treatment were 1.95 times more likely to survive and 2.74 times more likely to survive without major complications such as severe cerebral hemorrhage, lung disease severe (bronchopulmonary dysplasia), brain cysts, inflammation of the intestines (necrotizing enterocolitis) or abnormal growth of blood vessels in the retina (retinopathy of prematurity requiring treatment).
The study authors concluded that their findings provide strong evidence to support the administration of antenatal corticosteroid therapy to pregnant women at risk of delivery at 22 weeks.
Michele Walsh, MD, neonatologist in the pregnancy and perinatology branch of NICHD and project scientist for the NICHD Neonatal Research Network, is available for comment.
Chawla, S. Association of prenatal steroid exposure between 21 and 22 weeks of gestation with neonatal survival and morbidity-free survival. JAMA network open. 2022.doi:10.1001/jamanetworkopen.2022.33331
About Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD conducts research and education to understand human development, improve reproductive health, improve the lives of children and adolescents, and maximize the capabilities of all. For more information, visit https://www.nichd.nih.gov.
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