Beneficial effects of the combined use of prenatal corticosteroids and postnatal surfactant on preterm infants.
OBJECTIVE
Our objective was to test the hypothesis that prenatal maternal corticosteroids would improve the subsequent response of infants to surfactant treatments.


METHODS
We used the data bases of two recently published large multicenter trials of multidose surfactant treatments to retrospectively evaluate the possible interactions between maternal corticosteroids and randomized surfactant treatments on short-term ventilatory effects, complications of respiratory distress syndrome and prematurity, and 28-day death rates.


RESULTS
The combined use of corticosteroids and surfactant significantly decreased overall death and death caused by respiratory distress syndrome relative to either treatment alone. Ventilatory variables at 72 hours were improved in those infants receiving both treatments, and other major complications of prematurity also tended to have decreased incidences.


CONCLUSIONS
The combined use of prenatal corticosteroids, when indicated, and postnatal surfactant improves neonatal outcome.
Jobe
A H
AH
Division of Perinatal Research, Harbor-University of California, Los Angeles Medical Center, Torrance 90509.
Mitchell
B R
BR
Gunkel
J H
JH
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D001034:Apgar Score; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control; D007234:Infant, Premature; D015337:Multicenter Studies as Topic; D011181:Postnatal Care; D011247:Pregnancy; D011295:Prenatal Care; D011663:Pulmonary Surfactants / Q000627:therapeutic use*; D012119:Respiration / Q000187:drug effects; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D011663:Pulmonary Surfactants