INTRODUCTION: Absence of the end-diastolic flow (EDF) is associated with adverse neonatal outcome. Administration of β-methasone to women with a pregnancy complicated by absent EDF is associated with the transient return of EDF in up to 70% of cases.
OBJECTIVE: We aimed to compare the hospital outcome of preterm infants for whom the absent EDF returned after antenatal administration of β-methasone with those for whom the absent EDF did not return.
METHODS: At Monash Medical Center, 80 pregnant women with absent EDF were given 2 intramuscular 11.4-mg doses of β-methasone 24 hours apart. In the majority of pregnancies, EDF returned after β-methasone treatment. The preterm infants born to these 80 pregnant women had their hospital outcome ascertained retrospectively. Statistical analysis was performed by using the χ2 and Mann-Whitney rank-sum tests.
RESULTS: The 51 infants for whom the EDF returned were compared with the 29 for whom the EDF did not return. There were no significant differences in their gestational age, birth weight, or resuscitation and ventilation needs. The former group was less acidotic at birth (mean pH: 7.4 vs 7.3 [P < .05]; and mean base excess: −3 vs −5 mmol/L [P < .05]). There was no significant difference in the incidence of respiratory disease, intraventricular hemorrhage, necrotizing enterocolitis, and mortality rates.
CONCLUSIONS: Preterm infants born after return of an absent EDF after the administration of antenatal β-methasone were less acidotic at birth, but their hospital morbidity and mortality rates were not significantly improved compared with those for whom the absent EDF did not return.
Submitted by Florence Murila
- Copyright © 2008 by the American Academy of Pediatrics