Postnatal respiratory compliance among premature ventilated neonates associated with variable timing and dosing of antenatal steroids.
BACKGROUND
Antenatal steroids (ANSs) improve the respiratory compliance of premature infants. Many premature neonates are born before the administration of a complete course of ANS.


OBJECTIVE
The objective of this study was to evaluate the respiratory system compliance (Crs) of premature (≤ 32 weeks gestation), intubated neonates in relation to the dose, and timing of ANS administration.


METHODS
Neonates (n = 61) were divided into four groups based on the dose and timing of ANS exposure: Group 1: no ANS; Group 2: partial course (one dose of betamethasone); Group 3: complete course (two doses of betamethasone administered within 2 weeks of delivery); and Group 4: remote course (two doses of betamethasone administered > 2 weeks before delivery). Crs was measured by single-breath occlusion technique.


RESULTS
Indexed respiratory compliance ± standard error of the mean (mL/cmH2O/kg) adjusted for gestational ages were 0.359 ± 0.074, 0.366 ± 0.080, 0.625 ± 0.038, and 0.505 ± 0.060 for Groups 1 to 4, respectively. The mean indexed Crs in complete ANS was significantly higher than that of no ANS (0.266 ± 0.085; p = 0.016) as well as partial ANS group (0.259 ± 0.086; p = 0.025).


CONCLUSIONS
Crs after birth was significantly higher among premature intubated neonates born to mothers who received a complete course of ANS within 2 weeks, compared with no ANS or a partial course of ANS.
Division of Neonatal Perinatal Medicine, Hutzel Women's Hospital, Wayne State University, Detroit, Michigan.
Sanjay
S
Chawla
Division of Neonatal Perinatal Medicine, Hutzel Women's Hospital, Wayne State University, Detroit, Michigan.
Jorge
J
Lua
Division of Neonatal Perinatal Medicine, Hutzel Women's Hospital, Wayne State University, Detroit, Michigan.
Girija
G
Natarajan
Division of Neonatal Perinatal Medicine, Hutzel Women's Hospital, Wayne State University, Detroit, Michigan.
Josef Misael C
JM
Cortez
Division of Respiratory Therapy, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan.
Matthew
M
Gelmini
Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan.
Ronald
R
Thomas
Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, Michigan.
Ashok
A
Sarnaik
D001623:Betamethasone / Q000008:administration & dosage*; D001724:Birth Weight; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000503:physiopathology* / Q000628:therapy; D008170:Lung Compliance / Q000187:drug effects*; D008297:Male; D011181:Postnatal Care; D047928:Premature Birth / Q000188:drug therapy* / Q000503:physiopathology; D011295:Prenatal Care; D011446:Prospective Studies; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology* / Q000628:therapy; D012720:Severity of Illness Index
D005938:Glucocorticoids; D001623:Betamethasone