Historical Perspectives: The Underpinnings of Neonatal/Perinatal Medicine

Abstract

The second featured article in Historical Perspectives this month was published in 1972 in Pediatrics (1) and emanated from New Zealand. We asked Dr. Liggins to provide perspective on how antepartum corticosteroids were introduced. As he notes, it took many years before this treatment gained acceptance. Dr. Liggins attributes this (in part) to resentment by neonatologists that obstetricians were intruding on their territory. In contrast, our perception is that the delay in acceptance was largely because obstetricians were unwilling to accept something that appeared in the pediatric literature. There was also concern about the long-term outcome in these infants, although follow-up of the original cohort showed no apparent differences. (2) The consensus development conference on the “Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes” was held in early 1994 and published by the National Institutes of Health later that year. (3) This clearly documented advantages to antepartum corticosteroid administration not only with regard to respiratory distress syndrome, but also in reducing intraventricular hemorrhage and overall …