2005, Number 3-4
Perinatol Reprod Hum 2005; 19 (3-4)
Neonatal morbidity and mortality evaluation in the prenatal steroids use
Fernández-Carrocera LA, Curiel-León G, Delgadillo-Avendaño JM, Salinas-Ramírez V
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Prenatal steroids have been used to reduce the frequency of neonatal respiratory complications. 13 million of preterm births are reported annually. Nineteen point seven percent of the births at The National Institute of Perinatology in Mexico City are preterm. We want to know the risks of antenatal corticosteroid therapy in pregnant women with preterm labor.
Material and Methods:
We conducted a retrospective study in a third level hospital between January first 2002 and December 31 2003. Neonates with gestational ages between 26 and 32 weeks whose mothers received one or more antenatal corticosteroids therapy schemes (2 doses of 12 mg of intramuscu-lar betametasone with 24 hour interval or 4 doses or 6 mg of intramuscular dexamethasone) were included.
One hundred and eight clinical records were reviewed and divided into two different groups: Group I (n = 69) who received one antenatal steroid scheme and Group II (n = 39) with 2 or more antenatal steroids therapy schemes. Men gestational age was significantly lower, 28 weeks, in group I (p = 0.001). Premature rupture of membranes of 24 hour of duration or more was more frequent in group I and 65% of the neonates in this group required endotracheal intubation during neonatal reanimation and 59% of the neonates in group II. Required this maneuver. There was an increased risk of septicemia and death in group I. The principal cause of death in both groups was septic shock. The risk of death was higher in group I; OR 3.57 IC 95% 1.2,11.36.
According to this results we were no able te demonstrate that more than one maturation treatment schedule were benefitial in any way to the neonates.
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