Respiratory compliance in preterm infants after a single rescue course of antenatal steroids: a randomized controlled trial.
OBJECTIVE
To compare respiratory compliance and functional residual capacity in infants randomized to a rescue course of antenatal steroids vs placebo.


METHODS
Randomized, double-blinded trial. Pregnant women > or =14 days after initial antenatal steroids were randomized to rescue antenatal steroids or placebo. The primary outcomes were measurements of respiratory compliance and functional residual capacity. This study is registered with clinicaltrials.gov (NCT00669383).


RESULTS
Forty-four mothers (56 infants) received rescue antenatal steroids and 41 mothers (57 infants) received placebo. There was no significant difference in birthweight, or head circumference. Infants in the rescue group had an increased respiratory compliance (1.21 vs 1.01 mL/cm H(2)O/kg; adjusted 95% confidence interval, 0.01-0.49; P = .0433) compared with placebo. 13% in the rescue vs 29% in the placebo group required > or =30% oxygen (P < .05). Patients delivered at < or =34 weeks had greater pulmonary benefits.


CONCLUSIONS
Infants randomized to rescue antenatal steroids have a significantly increased respiratory compliance compared with placebo.
Division of Neonatology, Department of Pediatrics, Oregon Health and Science University, Portland, OR, USA. mcevoyc@ohsu.edu
Cindy
C
McEvoy
Diane
D
Schilling
Dawn
D
Peters
Carrie
C
Tillotson
Patricia
P
Spitale
Linda
L
Wallen
Sally
S
Segel
Susan
S
Bowling
Michael
M
Gravett
Manuel
M
Durand
D001623:Betamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005652:Functional Residual Capacity / Q000187:drug effects*; D005865:Gestational Age; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D057194:Intention to Treat Analysis; D008297:Male; D018579:Patient Selection; D011247:Pregnancy; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*; D015656:Respiratory Mechanics / Q000187:drug effects*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D005938:Glucocorticoids; D001623:Betamethasone