[Prenatal steroid treatment--a 4-year material]

Abstract

Prenatal steroids have been used for more than 20 years to prevent respiratory distress syndrome and death in preterm infants. Previously the treatment was recommended from the 28th to the 32nd gestational week. It is now recommended, with very few contradictions, from the 24th to the 33rd gestational week. From 1990 to 93, 56 (39%) of 145 infants under 33 weeks were given prenatal steroids. Amongst the steroid-treated infants there were significantly fewer deaths and fewer respiratory distress syndromes (3.6% vs 18%, p < 0.02 and 61% vs 82%, p < 0.01). Mortality at this age fell from 18% in 1990/1991 to 6% in 1992/1993 (p = 0.019), coinciding with an increase in the use of surfactant from 5% to 30% (p < 0.01) and prenatal steroids from 31% to 46% (p = 0.028). No specific complications that could be attributed to steroids were recorded in either mother or infant. Had the new recommendations applied, a further 28 infants under 33 gestational weeks (58% of all) would have been treated with prenatal steroids.