Prenatal steroid therapy for pregnant women may improve the survival of extremely premature infants

Prenatal steroid therapy for pregnant women may improve the survival of extremely premature infants

Steroid treatment before birth appears to improve survival and reduce complications in extremely premature babies, according to a study funded by the National Institutes of Health. Prenatal steroid therapy given to women at risk of preterm birth results in maturation of the fetal lungs and has been shown to improve survival and reduce complications in infants born at 24 to 34 weeks of gestation. However, previous studies treating infants born between 22 and 23 weeks - those at greatest risk of death and disability - have been inconclusive.

The study was conducted by Sanjay Chawla, MD, of Central Michigan University, Mount Pleasant, and Wayne State University, Detroit, and colleagues at 17 U.S. research institutions. It appears in JAMA Network Open. Funding was provided by the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Center for Advancing Translational Sciences.

Of the mothers of the 431 infants in the study, 110 received no steroid betamethasone, 80 received partial treatment (one dose), and 241 received full treatment (two doses 24 hours apart).

Of infants exposed to full treatment, 53.9% survived to hospital discharge, compared with 37.5% with partial treatment and 35.5% with no treatment. Compared to infants who received no treatment, infants exposed to full treatment were 1.95 times more likely to survive and 2.74 times more likely to survive without serious complications such as severe bleeding in the brain, severe lung disease (bronchopulmonary dysplasia), cysts in the brain, severe inflammation of the intestines (necrotizing enterocolitis) or abnormal blood vessel growth in the retina (retinopathy of prematurity requiring treatment).

The study authors concluded that their results provide strong evidence that prenatal steroid therapy should be given to pregnant women at risk of delivery at 22 weeks.

Source:

National Institutes of Health

Reference:

Chawla, S., et al. (2022) Association of prenatal steroid exposure at 21 to 22 weeks of gestation with neonatal survival and morbidity-free survival. JAMA network opened. doi.org/10.1001/jamanetworkopen.2022.33331.