Effects of antenatal steroids on the complications of prematurity in an era of surfactant replacement therapy in Oman.

Abstract

The aim of this study was to assess the effects of a complete course of antenatal steroids (dexamethasone 12 mg every 12 h x 2) on the complications of prematurity, in an era of surfactant replacement therapy in an Asian population. Between January 1995 and December 1998 we analysed all preterm births (-32 weeks) from women who had received antenatal care and delivered at our institution. Group A comprised those who did not receive, or received only an incomplete course of antenatal dexamethasone. Group B were those who received a complete course, i.e. delivered at least 24 h after commencing dexamethasone. There were 256 infants in Group A, and 168 in Group B. Mortality was significantly reduced (21.8 per cent in Group A vs. 10.7 per cent in Group B; p = 0.003), and the incidence of necrotising enterocolitis (NEC) was increased (2.7 per cent in Group A vs. 10.1 per cent in Group B;p = 0.001) in those whose mothers received dexamethasone. There was no difference in the incidence of respiratory distress syndrome (RDS), patent ductus arteriosus (PDA), chronic lung disease, major intraventricular hemorrhage (IVH) or PVL. There was, however, a trend towards an increased number of septic episodes in infants of Group B. It was concluded that antenatal steroids reduced mortality, but had no effect on the incidence of RDS, PDA, CLD, major IVH or PVL in an Asian population who were given surfactant for respiratory distress syndrome. There was a trend towards greater neonatal infections. These results need to be confirmed in similar population groups.