PEDIATRICS Vol. 82 No. 4 October 1988, pp. 543-547
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Two-Year Follow-up of Infants Enrolled in a Randomized Trial of Surfactant Replacement Therapy for Prevention of Neonatal Respiratory Distress Syndrome

Michael S. Dunn MD, FRCP(C)1, Andrew T. Shennan MB, MRCP(UK), FRCP(C)1, Elizabeth M. Hoskins MD, FRCP(C)1, Kathryn Lennox RN1, and Goran Enhorning MD, FRCS(C)1

1 From the Regional Perinatal Unit, Women's College Hospital, Toronto

A randomized clinical trial of the use of bovine surfactant for the prevention of neonatal respiratory distress syndrome was completed at our Institution in 1984 (Pediatrics 1985;76:145-153). All infants entering the trial were enrolled in our follow-up clinic and seen at regular intervals for assessment of growth and development, neurologic and sensory status, and incidence of respiratory disease and allergic conditions. Infants have now been followed-up for at least 2 years. Of those infants for whom follow-up is complete, two of 32 (6.3%) surfactant-treated infants died, five (15.6%) had major neurodevelopmental handicaps, and five had minor neurodevelopmental handicaps. In the control group, eight of 33 (24%) infants died, whereas only two (6.1%) survived with major neurodevelopmental handicaps, and four (12.1%) were left with minor handicaps. Except for an increased neonatal death rate in the control group, other differences were not statistically significant. The groups were also comparable in terms of the incidence of late respiratory or allergic disease as assessed by history. Treatment with bovine surfactant at birth of premature infants at high risk for respiratory distress syndrome appears to be safe and of short-term benefit, although no decrease in neurodevelopmental handicap at 2 years' follow-up can be demonstrated.

Key Words: surfactant replacement • neonate • respiratory distress syndrome

Submitted on December 7, 1987
Accepted on January 26, 1988




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