Antenatal glucocorticoid treatment does not reduce chronic lung disease among surviving preterm infants

• Published in: The Journal of pediatrics Vol. 138; no. 2; pp. 198 - 204
• Main Authors: Van Marter, Linda J., Allred, Elizabeth N., Leviton, Alan, Pagano, Marcello, Parad, Richard, Moore, Marianne
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01-02-2001; Elsevier
• Subjects: Biological and medical sciences; Chronic Disease; Diseases of mother, fetus and pregnancy; Drug Evaluation; Female; Gestational Age; Glucocorticoids - administration & dosage; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infant, Premature, Diseases - prevention & control; Infant, Very Low Birth Weight; Lung Diseases - prevention & control; Male; Medical sciences; Pneumology; Pregnancy; Pregnancy. Fetus. Placenta; Respiratory Distress Syndrome, Newborn - prevention & control; Respiratory system : syndromes and miscellaneous diseases; RDS; VLBW; PMA; FIO2; NICU; CLD; PDA; AGT; Human; Premature; Lung disease; Statistical analysis; Pregnancy disorders; Respiratory disease; Survivor; Deficiency; Multicenter study; Infant; Multivariate analysis; Risk analysis; Glucocorticoid; Very low birthweight; Prenatal; Logistic regression; Newborn diseases; Chemotherapy; Chronic; Treatment; Pulmonary surfactant; Respiratory distress; Influence
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1067/mpd.2001.110980

Background: Antenatal glucocorticoid treatment (AGT) is associated with a number of postnatal benefits to the preterm infant, including reduced risk of respiratory distress syndrome, patent ductus arteriosus, intraventricular hemorrhage, and necrotizing enterocolitis. Objective: To evaluate the hypothesis that maternal AGT not only reduces the risk of surfactant deficiency but also reduces the occurrence of chronic lung disease (CLD) among surviving preterm infants. Study Design: Case-referent study of 1454 very low birth weight infants born between January 1991 and December 1993 at 4 university medical centers. Results: Rates of AGT varied among the 4 centers (11%-69%), as did rates of CLD (4%-21%), defined as a requirement for supplemental oxygen at 36 weeks' postmenstrual age. CLD rates at each center, however, did not vary with the rate of AGT exposure. In multivariate logistic regression analyses, AGT did not contribute significantly to CLD risk. Conclusion: AGT may play a less prominent role in modifying CLD risk than other factors such as biologic immaturity, infection, or neonatal intensive care unit practices, such as mechanical ventilation, continuous positive airway pressure, and surfactant replacement therapy. (J Pediatr 2001;138:198-204)