Antenatal steroids and fluid balance in very low birthweight infants.
OBJECTIVE
To determine if insensible water loss (IWL) differed between infants exposed or not exposed antenatally to corticosteroids and to explore possible mechanisms for the early postnatal diuresis associated with antenatal steroid exposure.


METHODS
Retrospective analysis of prospectively collected data.


METHODS
Level three neonatal intensive care unit.


METHODS
Ninety six infants, median gestational age 27.5 weeks (range 23-33).


METHODS
Comparison of the IWL, urine output and osmolality, fluid input, electrolyte imbalance, respiratory illness severity (as assessed by surfactant requirement, maximum peak inspiratory pressure, and inspired oxygen concentration), and cardiovascular status (as assessed by inotrope requirement) between infants with antenatal corticosteroid exposure and gestational age matched controls.


RESULTS
The infants exposed to antenatal steroids differed significantly from the controls in having both a lower IWL (p = 0.0135) and a higher urine output (p = 0.0036) on day 1, and fewer developed hyponatraemia (p = 0.027) on day 2. Fewer of those exposed to antenatal steroids required inotropes (p = 0.06), but their respiratory status was similar to that of the controls.


CONCLUSIONS
Infants exposed to antenatal corticosteroids have a lower IWL. The results suggest that greater skin maturation, but also better perfusion rather than less severe respiratory status, explains the early diuresis in infants exposed to antenatal steroids.
Dimitriou
G
G
4th Floor, Golden Jubilee Wing, King's College Hospital, London SE5 9RS, UK.
Kavvadia
V
V
Marcou
M
M
Greenough
A
A
D000305:Adrenal Cortex Hormones / Q000494:pharmacology*; D002316:Cardiotonic Agents / Q000008:administration & dosage; D004231:Diuresis / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000503:physiopathology; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012120:Respiration Disorders / Q000503:physiopathology; D012189:Retrospective Studies; D014870:Water Loss, Insensible / Q000187:drug effects*; D014882:Water-Electrolyte Balance / Q000187:drug effects
D000305:Adrenal Cortex Hormones; D002316:Cardiotonic Agents