Effects of Antenatal Steroids with Magnesium Sulphate on Intraventricular Hemorrhage and Periventricular Leukomalacia in Neonates Born below 32 Weeks of Gestation

Abstract

Introduction: The most important acquired brain injuries in very and extremely preterm infants born in developing Country are periventricular-Intraventricular haemorrhages and diffuse white matter injury. Antenatal corticosteroids play a crucial role in its development. A study was conducted to determine effects of antenatal steroids along with magnesium sulphate on Intraventricular Hemorrhage and Periventricular Leukomalacia in preterm neonates.
 Methodology: A retrospective prospective cohort study conducted among premature newborn babies admitted in the hospital. Based on the antenatal medication subjects were divided in to three groups: Group 1: No Steroid and No MgsO4 in antenatal period; Group 2: Received complete and incomplete course of antenatal steroid; and Group 3: Received complete course of antenatal steroid and MgSO4. The Occurrence of IVH and/or PVL in the neonates during hospital stay in all 3 groups.
 Results: Among the 144 cases, 8 patients had IVH and 1 had PVL. No intervention group (No antenatal steroids/ antenatal MgSo4) had highest chances of development of IVH/PVL. Significantly lower rate of IVH/PVL recorded in ‘Steroid and MgSO4’ group compared to only ‘Steroid’ group. The chances of development of RDS, BPD and NEC in no intervention group (No antenatal steroids and antenatal MgSo4) was significantly higher compared to steroid and and MgSO4 group and Steroid only group.
 Conclusion: This study confirmed that antenatal steroids when used along with antenatal magnesium sulphate to deliver preterm babies reduce IVH and white matter brain injury significantly.