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Steroids May Boost Survival for Premature Babies

Giving steroids to pregnant woman at risk for preterm birth - even as early as 22 weeks - may boost the child’s overall survival rate, reducing its risk for death and other long-term complications like cerebral palsy, poor motor skills and lower intelligence, a new study shows.

Dr. Wally Carlo, director of the Division of Neonatology at the University of Alabama at Birmingham led this study using data collected prospectively on babies born from January 1993 to January. 2009 at academic medical centers across the country. These babies were bon at 22 to 25 weeks gestation weighing between just under a pound to 2 pounds.

Carlo and his research team wanted to determine if antenatal corticosteroids worked as well in early premature babies, even in the long run, as they do in babies born at 26 weeks gestation and older.

This type of steroid, antenatal corticosteroids, when administered to women in preterm labor, mature the lungs and other organs in their baby’s body. Two shots of the steroids have been recommended for women in premature labor as early as 24 weeks, but there were no data available for 23 weeks or earlier gestation from the controlled, randomized trials, Carlo says. And the available data was also limited in trials for pregnancies at 24 and 25 weeks.

Carlo said there was very limited data on long-term outcomes for these pre-term babies, which is quite significant because it is important to increase both survival and quality of life, he said.

“We wanted to study the smallest premature babies because this is a very large population of infants,” Carlo said. However, physicians differ in the practice of administering antenatal corticosteroids to women at these gestational ages.

Carlo also says there have been concerns about giving these steroids to some women who are experiencing early premature labor, especially those who are susceptible to infection, because steroids lower the body’s ability to fight infection.

“The results of the study showed that mortality was decreased by more than 33 percent and neurodevelopmental impairment was decreased by more than 20 percent,” Carlo says.

The study‘s authors note that even extremely premature infants, at 22 to 25 weeks, respond as well as more mature infants. And using this steroid did not increase the mothers’ infection rate.

Carlo says the study is important because it shows that a low-cost intervention, about $25 for two shots, gives even the earliest preemies a chance to survive and thrive.

For more on child safety issues, see the library of articles by Daytona Beach child injury attorney.

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