PEDIATRICS Vol. 63 No. 1 January 1979, pp. 64-72
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Risk of Respiratory Distress Syndrome After Prenatal Dexamethasone Treatment

H. William Taeusch Jr. M. D.1, Frederic Frigoletto M. D.1, John Kitzmiller M. D.1, Mary Ellen Avery M. D.1, Ann Hehre R. N.1, Barbara Fromm MA.1, Edward Lawson M. D.1, and Raymond K. Neff Sc. D.1

1 Departments of Pediatrics and Obstetrics and Gynecology, Harvard Medical School, Boston Hospital for Women, Beth Israel Hospital, the Health Sciences Computing Facility, and the Department of Biostatistics, Harvard School of Public Health, Boston

A prospective double-blind randomized clinical trial was carried out to determine whether glucocorticoid treatment reduces the risk of respiratory distress syndrome (RDS) in prematurely born infants. There were 127 infants born to 122 mothers who received either steroid (dexamethasone phosphate) or placebo. No differences between groups occurred in risk factors for RDS (eg, prepartum asphyxia, male sex, cesarean section). When those who received a full course of dexamethasone therapy were compared with those who received placebo, a significant reduction was found in risk, severity, and deaths due to RDS. An increased incidence of infection in mothers treated with steroid was evident, particularly after premature rupture of membranes. We conclude that steroids are effective in reducing risk of RDS, but safer and more efficacious approaches for the prevention of RDS should be sought.

Submitted on August 28, 1978
Accepted on October 19, 1978




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