Author: Nagy Iulia Andrea Coordinator: Simon Márta, PhD, Lecturer Coauthor: Ortopan Maria, Oana Andrea Edina

PREMATURITY < 37 weeks of gestation Lack of SURFACTANT synthesis Immature Type II Pneumocytes Alveolar collapse V/Q Mismatch

 HYPOXEMIA  HYPERCARBIA  CYANOSIS  RESPIRATORY AND METABOLIC ACIDOSIS  DEATH

 Corticosteroids administered to women at risk of preterm delivery will cross blood placental barrier and help enhancing fetal lung maturation  Steroids used are usually:  Treatment is given IM Dexamethasone (6 mg) - 4 doses 12 hrs apart Betamethasone (12 mg) - 2 doses 24 hrs apart

 Antenatal Corticosteroid apart from reducing RDS severity also reduce:  Complications, among preterm infants  Intrahospital mortality

Objectives  to determine the benefits of antenatal corticosteroids in leading to better outcomes in preterm infants Material and Method:  retrospective observational study  219 premature babies of weeks, with RDS, treated in Mures Country NICU between

 Newborns were divided into two groups: group 1- babie whose mothers received corticosteroids group 2- babies with no prophylactic corticotherapy.

APGAR scoreGroup 1 (n=107) Group 2 (n=112) P -value 1 st minute th minute Group 1Group 2P-value Total stay in hospital (days) * 4 deaths * 12 deaths Mean Apgar score at 1 and 5 minutes after birth in: group 1- newborns exposed to ACS and group 2- newborns without ACS Mean length of hospital stay in the two groups

 Percentage of antenatal corticotherapy Antenatal exposure at corticosteroids No of pregnancies % YES10748,9% NO11251,1% Total % About 51 % of the women couldn’t get ACS

CORTICOTHERAPYMECHANICAL VENTILATION TOTAL YESNO YES % % % NO % % % TOTAL % % % P =0.03

CORTICOTHERAPYIVHTOTAL YESNO YES % % % NO % % % TOTAL % % % P= 0.03

CORTICOTHERAPYNo. of NEONATAL DEATHS TOTAL YESNO YES4 25 % % % NO12 75 % % % TOTAL % % % P= 0.04

 Prenatal corticotherapy was associated with clinical outcome improvements in neonates with RDS  We found statistically significant correlations (p<0.05) between antenatal exposure at corticosteroids and :  a higher APGAR score  a decreased need for mechanical ventilation in moderate preterm infants  A reduced risk of IVH, in infants with BW <1500 g  A lower rate of neonatal mortality