Abstract

CASTRO ACUNA, Virya Elena; MANRIQUE ZULUAGA, Antonio José; CELADA QUEZADA, Rolando  and  OLIVARES VASSALLO, Samuel. El efecto de la administración de dexametasona materna en la prevención del síndrome de distréss respiratorio en el neonato prematuro. Rev. costarric. cienc. méd [online]. 1998, vol.19, n.1-2, pp.37-48. ISSN 0253-2948.

Clinical trials of antenatal steroids used in pregnant women between 24 and 34 weeks of gestation have demonstrated a reduction in hyaline membrane, broncopulmonary dysplasia, intraventricular hemorrage, necrotizing enterocolitis, sepsis, and premature retinopathy. We decided to conduct a retrospective cohort study since the doses of dexamethasone that have improved neonatal outcome are different than those used in the Hospital San Juan de Dios. We analized a group of 162 women, of which 77 had been exposed to two doses of dexamethasone (12 mg each 12-24 hours IM) and 85 were not exposed. There were no statistically significant diferences between cohorts in the incidence of hyaline membrane (p=0.27), broncopulmonary dysplasia (p=0.85), premature retinopathy (0.15), necrotizing enterocolitis (p=0.48) and sepsis (p=0.48). Only a significant reduction was found in the incidence of intraventricular hemorrage (p=0.019) in exposed neonates. With respect to perinatal mortality and total time of neonatal hospitalization, no diferences were found. In conclusion, the use of antenatal dexamethasone at the doses used in the Hospital San Juan de Dios, did not improve the outcome in premature neonates between 24 and 34 weeks ; we only confirm a protection for the development of intraventricular hemorrage.

Keywords : Premature; newborn; dexamethasone; pulmonary maturity; hyaline membrane; broncopulmonary dysplasia; intraventricular hemorrage.