  
Antenatal steroids may improve outcome in preemies after prolonged ventilation
Last Updated: 2001-04-30 12:26:05 EDT (Reuters Health)
LONDON (Reuters Health) - Treatment with antenatal steroids and exogenous surfactant is associated with improved survival and neurodevelopmental outcome after prolonged ventilation in preterm neonates, according to study results published in the May issue of Archives of Disease in Childhood, Foetal Neonatal Edition.
Investigators from Liverpool Women's Hospital reviewed the medical records of 84 infants treated with antenatal steroids and surfactant and who required mechanical ventilation beyond 27 postnatal days.
The overall survival rate was 73%. According to Dr. N. J. Shaw and colleagues, 86% of 56 infants who required mechanical ventilation beyond 27 but not 50 postnatal days survived to age 3. Fifty four percent of the survivors had normal neurodevelopment, 15% had mild disability, 23% had moderate disability and 8% had severe disability at age 3.
The remaining 28 infants, who required mechanical ventilation beyond 49 postnatal days, did not fare as well. Only 50% survived to age 3. Thirty six percent had normal neurodevelopment, 14% had mild disability, 29% had moderate disability and 21% had severe disability at age 3.
"The improved outcome...in our cohort of babies is likely to be due to the use of antenatal steroids and exogenous surfactant," Dr. Shaw and colleagues write. The results also clearly show that "survival decreases with more prolonged ventilation," they point out. "This information will be useful when advising parents about the prognosis of their baby if they are ventilator dependent beyond 27 days."
Arch Dis Child Fetal Neonatal Ed 2001;84:F194-F196.
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