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Pulmonary function and outcomes in infants randomized to a rescue course of antenatal steroids
Author(s) -
McEvoy Cindy,
Schilling Diane,
Spitale Patricia,
O'Malley Jean,
Bowling Susan,
Durand Manuel
Publication year - 2017
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23711
Subject(s) - medicine , pulmonary function testing , placebo , randomized controlled trial , respiratory system , functional residual capacity , pediatrics , anesthesia , surgery , lung volumes , lung , alternative medicine , pathology
Background/Objective Our objective was to obtain follow‐up pulmonary function testing and assessment of clinical respiratory outcomes, at 1‐2 years, in preterm infants whose mothers were randomized to a single rescue course of antenatal steroids (AS) versus placebo. Methods Follow‐up of a randomized, double‐blinded trial. In the original trial pregnant women ≥14 days after initial course of AS were randomized to rescue AS or placebo. Pulmonary function testing and a standardized respiratory questionnaire were obtained at 1‐2 years of corrected age. Respiratory compliance (Crs) was measured with the single‐breath occlusion and functional residual capacity (FRC) with the nitrogen washout method. Analysis was by intention‐to‐treat. Results A total of 96 (87%) of available survivors were administered a respiratory questionnaire. Seventy‐seven percent of available patients had pulmonary function testing performed. There was no significant difference between groups in incidence of wheezing, asthma, respiratory syncytial virus infection, respiratory readmissions, use of bronchodilators or other medications, or in measurements of pulmonary function. There was also no significant difference in corrected age at study, race, gender, or length at the time of pulmonary function testing. Infants in the rescue group had a comparable mean FRC (249.4 mL vs 246.2 mL; adjusted 95%CI for difference −15.45, 38.20; P = 0.37) versus placebo. There were no differences in tidal volume or Crs. Conclusion A rescue course of AS significantly increases Crs within 72 h of age and decreases oxygen need in newborn infants, without an adverse impact on pulmonary function or clinical respiratory outcomes at 1‐2 years of age [NCT00669383].