Prenatal prophylaxis of hyaline membrane disease with prednisolone: advantages and disadvantages

Abstract

The purpose of the study was to evaluate the prophylaxis of hyaline membrane disease (HMD) with prenatal steroids from the viewpoint of neonatology. In 397 preterm infants of 27-35 week gestation the prenatal prophylaxis of HMD with prednisolone (200-300 mg over 48-72 h) significantly reduced the HMD morbidity and mortality rate (0-7th day of life), especially in newborns under 33-week gestation. HMD was not detected if a 48-h interval lay between the end of prednisolone application and birth. There was no influence on the severity and the lethality of HMD. The 29-day mortality rate in the prednisolone group (14.6%) corresponded more or less to that of the control group (16%). In the prednisolone group the increase in late mortality rate was due to a significantly higher number of late serious infections. The time interval between the rupture of the membranes and birth did not influence the infection rate and HMD frequency. At this time we cannot recommend a general prenatal glucocorticoid prophylaxis of HMD in cases of threatened preterm labor.