Antenatal corticosteroids appear to reduce the risk of postnatal germinal matrix hemorrhage in intubated low birth weight newborns.
OBJECTIVE
To determine to what extent the reduced risk in preterm newborns of intracranial hemorrhage attributed to antenatal corticosteroids (ANCS) reflects reductions in the incidence of respiratory distress and its correlates.


METHODS
In a sample of 239 very low birth weight newborns recruited for a clinical trial of phenobarbital prophylaxis of subependymal/intraventricular hemorrhage, we explored the relationship between ANCS, the occurrence of germinal matrix hemorrhage (GMH) that first became evident after the 12th postnatal hour, and putative intervening variables such as acidosis, elevated peak inspiratory pressure, pneumothorax-pulmonary interstitial emphysema, and elevated continuous positive airway pressure.


RESULTS
In multivariate models adjusting for confounders, newborns exposed to ANCS were at approximately one third the risk of GMH experienced by newborns not exposed to a full course of ANCS. The additions of measures and correlates of respiratory distress severity to these models did not change the GMH risk associated with ANCS.


CONCLUSIONS
The GMH-protective effect of ANCS does not appear to be a consequence of enhanced pulmonary maturation.
Children's Hospital, Boston, MA 02115.
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Leviton
K C
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Kuban
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Pagano
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EN
Allred
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Van Marter
D002543:Cerebral Hemorrhage / Q000209:etiology / Q000517:prevention & control*; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology / Q000517:prevention & control*; D016015:Logistic Models; D010634:Phenobarbital / Q000627:therapeutic use; D011295:Prenatal Care; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications / Q000517:prevention & control / Q000628:therapy
D005938:Glucocorticoids; D010634:Phenobarbital