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LETTER TO EDITOR
Year : 2015  |  Volume : 4  |  Issue : 4  |  Page : 291-292

Effect of single dose antenatal steroid for pregnant mothers with high risk of preterm delivery on the respiratory outcome of neonates


Department of Paediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, Iraq

Date of Web Publication16-Oct-2015

Correspondence Address:
Mahmood Dhahir Al-Mendalawi
P.O. Box 55302, Baghdad Post Office, Baghdad
Iraq
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2249-4847.167412

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How to cite this article:
Al-Mendalawi MD. Effect of single dose antenatal steroid for pregnant mothers with high risk of preterm delivery on the respiratory outcome of neonates. J Clin Neonatol 2015;4:291-2

How to cite this URL:
Al-Mendalawi MD. Effect of single dose antenatal steroid for pregnant mothers with high risk of preterm delivery on the respiratory outcome of neonates. J Clin Neonatol [serial online] 2015 [cited 2019 Dec 6];4:291-2. Available from: http://www.jcnonweb.com/text.asp?2015/4/4/291/167412

Sir,

I read with interest the study by Gaur et al. on the effect of single dose antenatal corticosteroid (ACS) for pregnant mothers with a high risk of preterm delivery on the respiratory outcome of neonates.[1] Since respiratory distress syndrome (RDS) is one of the most common complications in preterm babies with substantial morbidity and mortality, a single course of corticosteroids is now widely recommended for the pregnant mothers between 24 and 34 weeks of gestation who are at a risk of preterm delivery within the next 24 h to 7 days.[2] Gaur et al.[1] addressed in their study a puzzling situation at the emergency department (ED) involving managing mothers at a risk of prematurely delivering neonates with potential RDS. The protocol adopted in their study, which consisted of administering a single dose of 24 mg of betamethasone injection on arrival to ED, did not reveal any significant improvement in the respiratory outcome of neonates. The authors attributed that to the small cohort size. I presume that there is another methodological limitation. The study did not include a control group for comparison which did not allow Gaur et al.[1] to make a firm conclusion. An interesting case–control Bosnian study was conducted to assess the effectiveness of ACS in decreasing RDS incidence in optimal delivery-treatment interval, in comparison to babies delivered before and after the optimal treatment interval has elapsed. The case group included preterm babies between 26 and 34 gestational weeks, whose mothers received ACS, while the control group consisted of babies of the same gestational age, whose mothers did not received ACS. The study showed that RDS was significantly less frequent in babies antenatally treated by corticosteroid than in babies whose mothers did not received corticosteroids before delivery. The majority of babies (54.67%) were born in optimal interval, 24 h to 7 days from the beginning of the steroid treatment, 32.0% children were born within 24 h, and 13.3% were born more than 7 days after the start of steroid treatment. Comparing the incidence of RDS between groups of babies born in the optimal treatment-delivery interval (1–7 days) and in the group of babies born within 24 h or after 7 days from the beginning of the treatment, no significant difference was found. The effect was clinically comparable, which suggests the possibility of reduction of treatment-delivery interval in acute clinical conditions.[3] Accordingly, I presume that despite the nonsignificant improvement in the respiratory outcome of neonates born within 24 h of ACS administration to mothers in the study by Gaur et al.,[1] the management protocol adopted by Gaur et al.[1] is still worthy to be employed in the clinical settings in developing countries with limited resources and poorly booked antenatal healthcare visits such as India.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Gaur KV, Nimbalkar SM, Desai R, Ganguly BP. Effect of single dose antenatal steroid for pregnant mothers with high risk of preterm delivery on the respiratory outcome of neonates. J Clin Neonatol 2015;4:217.   Back to cited text no. 1
  Medknow Journal  
2.
Sweet DG, Carnielli V, Greisen G, Hallman M, Ozek E, Plavka R, et al. European consensus guidelines on the management of neonatal respiratory distress syndrome in preterm infants-2013 update. Neonatology 2013;103:353-68.   Back to cited text no. 2
    
3.
Heljic S, Maksic H, Misanovic V, Dizdarevic J. Antenatal corticosteroids in respiratory distress syndrome prevention: Efficacy in relation to treatment - Delivery interval. Med Arh 2009;63:200-2.  Back to cited text no. 3
    




 

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