Çocuk Sağlığı ve Hastalıkları Dergisi 2007 , Vol 50 , Num 2
The effect of antenatal corticosteroids on neonatal mortality and morbidity
Didem Armangil1, Şule Yiğit2, Gülsevin Murat Yurdakök2, Ayşe Korkmaz4
1Hacettepe Üniversitesi Tıp Fakültesi Pediatri Uzmanı
2Hacettepe Üniversitesi Tıp Fakültesi Pediatri Profesörü
3Hacettepe Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Profesörü
4Hacettepe Üniversitesi Tıp Fakültesi Pediatri Doçenti
Armangil D, Yiğit Ş, Tekinalp G, Durukan T, Yurdakök M, Korkmaz A. (Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey). The effect of antenatal corticosteroids on neonatal mortality and morbidity. Çocuk Sağlığı ve Hastalıkları Dergisi 2007; 50: 79-90.

In this retrospective study, our aim was to compare the complication rates and outcome in neonates who are or were not administered antenatal betamethasone and to evaluate the effects of whether to use single or multiple courses of therapy. 843 premature infants with gestational age ranging from 22 to 34 weeks between January 1995 and January 2005 were evaluated in our study. One hundred and seventeen (25.6%) 458 (54.3%) infants administered antenatal betamethasone and infants who did not receive betamethasone therapy developed RDS, and the difference between groups was statistically significant (p<0.01). The use of antenatal corticosteroid decreased the necessity of mechanical ventilation (p<0.001) and the need for surfactant therapy (p<0.05). Steroids are found to be effective in reducing RDS at 29 weeks and later (p<0.05) and relatively ineffective under 28 weeks. Sepsis was observed in 48 (10.5%) infants whose mothers received antenatal corticosteroid therapy and in 67 (17.4%) infants whose mothers did not receive antenatal corticosteroid therapy, and the difference was statistically significant (p<0.01). When single course and multiple course betamethasone treatment modality was compared, it was shown that repeated use of betamethasone is associated with a significant decrease in RDS, need of surfactant, necessity of mechanical ventilation (p<0.05) and in necrotizing enterocolitis (p<0.01). On the other hand, it is also associated with high rates of maternal infection (p<0.05). It should be kept in mind that antenatal glucocorticoid treatment with weekly courses may have adverse effects on the central nervous system and neuromotor development and should thus not be routinely used. Anahtar Kelimeler : antenatal kortikosteroid, fetal akciğer matürasyonu, prematüre, yenidoğan, antenatal corticosteroid, fetal lung maturation, premature, newborn

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