Elsevier

The Journal of Pediatrics

Volume 201, October 2018, Pages 21-26
The Journal of Pediatrics

Original Articles
Respiratory Compliance in Late Preterm Infants (340/7-346/7 Weeks) after Antenatal Steroid Therapy

https://doi.org/10.1016/j.jpeds.2018.05.037Get rights and content

Objective

To compare respiratory compliance in late preterm infants (340/7-346/7 weeks) who received antenatal steroids vs matched late preterm infants who did not receive antenatal steroids.

Study design

This was a single-center prospective cohort study. Patients were matched for birth weight, gestational age, race, and sex. Respiratory compliance was the primary outcome measured with the single breath occlusion technique.

Results

We studied 25 late preterm infants treated with antenatal steroids and 25 matched infants who did not receive antenatal steroids. The treated infants had a significantly increased respiratory compliance/kg (adjusted 95% CI 0.05, 0.49; P = .016) and fewer required continuous positive airway pressure (P = .007) or >24 hours of supplemental oxygen (P = .046). There was no difference in surfactant therapy.

Conclusions

Respiratory compliance was significantly increased in this cohort of late preterm infants born at 340/7-346/7 weeks who received antenatal steroids compared with matched infants who did not receive antenatal steroids. Although not randomized, these data provide physiologic support for the possible beneficial effects of antenatal steroids in late preterm infants.

Section snippets

Methods

This prospective cohort study was done in the Neonatal Intensive Care Unit at Oregon Health and Science University in Portland, Oregon. The study was approved by the Institutional Review Board of the hospital and informed consent was obtained from the parents. Patients were enrolled between September 2009 and March 2010. Inclusion criteria for the study group included (1) infants born at a gestational age 340/7-346/7 weeks treated with antenatal steroids as part of clinical care; (2) maternal

Results

The primary reason for preterm delivery in both groups was preterm labor, followed by hypertension/preeclampsia and antepartum hemorrhage (Table I). The antenatal steroids-treated group included 7 sets of twins and the untreated group included 5 sets of twins. Both groups had the same percent of Caucasian and female infants, and similar birth weights. The mean gestational age of the treated group was 34.1 vs 34.3 weeks in the untreated group. This was statistically different because of the very

Discussion

This prospective cohort study demonstrates that late preterm infants (340/7-34 6/7 weeks of gestation) treated with antenatal steroids as part of clinical care prior to delivery had significantly increased Crs (25% higher) compared with matched infants who did not receive antenatal steroid therapy. This increased Crs also correlated with improved clinical respiratory outcomes, as significantly less of the infants treated with antenatal steroids required any CPAP and significantly less required

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    Supported by National Center for Advancing Translational Sciences/National Institutes of Health (NIH; UL1TR000128), NIH/NHLBI (K23 HL080231 and R01 HL105447), Office of Dietary Supplement, and American Lung Association to CTM. The authors declare no conflicts of interest.

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