Steroids boost survival, reduce brain injury for infants born at 23 weeks
Prenatal steroids—given to pregnant women at risk for giving birth prematurely—appear to improve survival and limit brain injury among infants born as early at the 23rd week of pregnancy.
Akinso: A full term pregnancy is 40 weeks. Infants born pre-term, in the 22nd through the 25th week of pregnancy are the smallest, most frail category of newborns. Many die soon after birth, despite the best attempts to save them, including the most sophisticated newborn intensive care available. Some survive, and reach adulthood relatively unaffected. The rest experience some degree of lifelong disability, including minor hearing loss, cerebral palsy, and intellectual disability.
Higgins: In 1995 the NIH published a statement on antenatal steroids for mothers with threaten preterm delivery.
Akinso: Dr. Rosemary Higgins is a board-certified neonatologist at the NIH.
Higgins: Prior studies have showed that steroids improved the baby's lung maturation. They reduce new problems such as respiratory distress syndrome.
Akinso: Increased lung development improves the chances for survival and may decrease the risk of brain injury. A recent study has been conduct by researchers participating in the NIH's Neonatal Research Network. Before this present study, little information was available to guide practitioners in use of prenatal steroids for infants before the 24th week.
Higgins: NIH consensus statement recommended steroids for 24-34 weeks. There's much practice variability. Based on those recommendations some physicians would follow them very rigidly and not offer steroids at less than 24 weeks which would be well within the practice guideline. However some physicians felt that if there could potentially be a benefit they would give steroids.
Akinso: To conduct the study, researchers analyzed medical records from network hospitals for about 10,500 infants born preterm from 1993 to 2009. The researchers also performed neurological examinations on the 4,924 surviving infants who were born between 1993 and 2008. The examinations were conducted 18-22 months after the infants' original due dates. Dr. Higgins sums up what was found when the mothers were given the steroids.
Higgins: When the physicians admitted the steroids to the mothers before the baby was born, overall in the whole group study from 22 to 25 weeks, there was an improved survival rate as well as the neurodevelopmental outcome at 18 to 22 months.
Akinso: Dr. Higgins says these findings provide strong evidence that prenatal steroids can benefit infants born as early as the 23rd week of pregnancy. For more information, visit www.nichd.nih.gov. For NIH Radio this is Wally Akinso— NIH...Turning Discovery Into Health®
About This Audio Report
Reporter: Wally Akinso
Sound Bite: Dr. Higgins
Topic: prenatal, steroids, pre-term, infants, premature, birth