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The Effectiveness Of
Antenatal Corticosteroid Therapy
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Am J Obstet Gynecol. 1993 Feb;168(2):508-13.
Beneficial effects of the combined use of prenatal corticosteroids and
postnatal surfactant on preterm infants.
Jobe AH, Mitchell BR, Gunkel JH.
Division of Perinatal Research, Harbor-University of California, Los
Angeles Medical Center, Torrance 90509.
Objectives:
Our objective was to test the hypothesis that prenatal
maternal corticosteroids would improve the subsequent response of
infants to surfactant treatments.
Study Design:
We used the data bases
of two recently published large multicenter trials of multidose
surfactant treatments to retrospectively evaluate the possible
interactions between maternal corticosteroids and randomized surfactant
treatments on short-term ventilatory effects, complications of
respiratory distress syndrome and prematurity, and 28-day death rates.
Results:
The combined use of corticosteroids and surfactant
significantly decreased overall death and death caused by respiratory
distress syndrome relative to either treatment alone. Ventilatory
variables at 72 hours were improved in those infants receiving both
treatments, and other major complications of prematurity also tended to
have decreased incidences.
Conclusion:
The combined use of prenatal
corticosteroids, when indicated, and postnatal surfactant improves
neonatal outcome.