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  • Title: Postnatal respiratory compliance among premature ventilated neonates associated with variable timing and dosing of antenatal steroids.
    Author: Chawla S, Lua J, Natarajan G, Cortez JM, Gelmini M, Thomas R, Sarnaik A.
    Journal: Am J Perinatol; 2014 Dec; 31(12):1073-8. PubMed ID: 24705966.
    Abstract:
    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. STUDY DESIGN: 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.
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