Prenatal steroid therapy cuts the risk of respiratory illnesses in babies born at 34-36 weeks, a new study has found.
Steroids are often prescribed to women who are likely to give birth before 34 weeks of pregnancy because the drugs reduce respiratory and other complications, as well as death, among infants born early preterm.
Now, researchers at a National Institutes of Health research network have reported that steroids also lower the risk of serious respiratory complications in late preterm infants.
Dr Uma Reddy, of the pregnancy and perinatology research branch at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), said that 8% of all deliveries happen in late preterm and its research indicates that providing prenatal steroid therapy for these women could greatly reduce the rate of their babies having serious respiratory complications.
The study, currently unpublished, enrolled 2,831 women, all of whom were between 34 and 28 weeks’ pregnant and were at high risk for delivering early.
The women were randomly assigned to receive two injections of the steroid betamethasone or a placebo, 24 hours apart.
The researchers categorised the study findings into a single composite measure, a primary outcome derived from the need for any of a number of therapies used to treat difficulty in breathing in the new-borns, including: continuous positive airway pressure (CPAP); oxygen therapy; and mechanical ventilation.
If the baby was stillborn or died within 72 hours was also included in the primary outcome.
At the end of the study, they found that 11.6% of the babies in the betamethasone group had had a 20% reduction in the need for respiratory support by 72 hours of age, compared to the placebo group.
Among secondary outcomes that were evaluated, severe respiratory illness included the need for CPAP therapy or supplemental oxygen for at least 12 continuous hours, a high concentration of oxygen for at least 24 hours, or mechanical ventilation.
The betamethasone group fared better, with 8.1% achieving the desired outcome of a 33% reduction in serious respiratory illness compared to the placebo group.
Babies in the betamethasone group also were less likely to experience transient tachypnea or bronchopulmonary dysplasia.
However, they were more likely to have low blood sugar compared with the placebo group (24% compared with 14.9%).
“Reducing neonatal respiratory complications could result in less injury to the immature lung, less hospitalisations, earlier infant-mom bonding, and better long-term lung and general health,” added Dr Carol Blaisdell, NHLBI medical officer and study program officer.
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