Register for Prenatal Corticosteroid Treatment Reduces Incidence and Severity
Respiratory Distress SyndromeOctober 30, 2000
(NewsRx.com) -- A study by investigators in The Netherlands shows, for the first time, that prenatal corticosteroid treatment increases surfactant phosphatidylcholine (PC) production from the precursor glucose in preterm infants who have severe respiratory distress syndrome (RDS).
After very premature delivery, many infants develop RDS, which is caused by primary surfactant deficiency. (Surfactants are lipoproteins that alter surface tension of fluids in the lungs and facilitate gaseous exchange in the tiny air sacs of the lungs by preventing their collapse.) Prenatal corticosteroid administration in women at risk for very premature delivery reduces the incidence and severity of RDS. The researchers noted that accelerated development of the surfactant system is part of the enhanced integrated development of the lung.
Writing in the September 2000 issue of the American Journal of Respiratory and Critical Care Medicine, Luc J.I. Zimmermann, MD, PhD, Neonatology, Sophia Children's Hospital, Rotterdam, The Netherlands, together with five associates, studied endogenous surfactant synthesis in relation to prenatal corticosteroid treatment in 27 preterm infants with RDS. The infants received a 24-hour infusion of a stable isotope glucose starting five hours after birth. The investigators tested 11 infants who received no prenatal steroid, four who had one dose, and 12 who received two doses.
The researchers reported that the RDS grade and number of days ventilation, plus other factors such as gestational age and birth weight, etc., were comparable for all groups of infants.
They found significantly increased surfactant PC synthesis with glucose. Their data showed an increase of 40% per dose of prenatal corticosteroid. But the investigators commented that the development of surfactant metabolism in these infants is a slow process.
"Prior to this clinical study, we found that in very preterm baboons who received surfactant and were ventilated for six days, surfactant PC synthesis from glucose approximately doubled after two prenatal doses of corticosteroid, which is comparable with the findings in the present study," Zimmermann explained.
This article was prepared by Health & Medicine Week editors from staff and other reports.
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