Document Detail


Antenatal corticosteroids appear to reduce the risk of postnatal germinal matrix hemorrhage in intubated low birth weight newborns.
MedLine Citation:
PMID:  8502506     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine to what extent the reduced risk in preterm newborns of intracranial hemorrhage attributed to antenatal corticosteroids (ANCS) reflects reductions in the incidence of respiratory distress and its correlates. METHODS: In a sample of 239 very low birth weight newborns recruited for a clinical trial of phenobarbital prophylaxis of subependymal/intraventricular hemorrhage, we explored the relationship between ANCS, the occurrence of germinal matrix hemorrhage (GMH) that first became evident after the 12th postnatal hour, and putative intervening variables such as acidosis, elevated peak inspiratory pressure, pneumothorax-pulmonary interstitial emphysema, and elevated continuous positive airway pressure. RESULTS: In multivariate models adjusting for confounders, newborns exposed to ANCS were at approximately one third the risk of GMH experienced by newborns not exposed to a full course of ANCS. The additions of measures and correlates of respiratory distress severity to these models did not change the GMH risk associated with ANCS. CONCLUSION: The GMH-protective effect of ANCS does not appear to be a consequence of enhanced pulmonary maturation.
Authors:
A Leviton; K C Kuban; M Pagano; E N Allred; L Van Marter
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Pediatrics     Volume:  91     ISSN:  0031-4005     ISO Abbreviation:  Pediatrics     Publication Date:  1993 Jun 
Date Detail:
Created Date:  1993-06-28     Completed Date:  1993-06-28     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1083-8     Citation Subset:  AIM; IM    
Affiliation:
Children's Hospital, Boston, MA 02115.
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MeSH Terms
Descriptor/Qualifier:
Cerebral Hemorrhage / etiology,  prevention & control*
Glucocorticoids / administration & dosage,  therapeutic use*
Humans
Infant, Low Birth Weight*
Infant, Newborn
Infant, Premature, Diseases / etiology,  prevention & control*
Logistic Models
Phenobarbital / therapeutic use
Prenatal Care*
Respiration, Artificial
Respiratory Distress Syndrome, Newborn / complications,  prevention & control,  therapy
Grant Support
ID/Acronym/Agency:
HD 18655/HD/NICHD NIH HHS; NS 20658/NS/NINDS NIH HHS; NS 20807/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Glucocorticoids; 50-06-6/Phenobarbital

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