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

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

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

4.  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

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

6. 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 24-36 weeks, with RDS, treated in Mures Country NICU between 2012-2013

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

8. APGAR scoreGroup 1 (n=107) Group 2 (n=112) P -value 1 st minute7.356.380.0005 5 th minute8.237.570.0012 Group 1Group 2P-value Total stay in hospital (days) 29.27 * 4 deaths 22.95 * 12 deaths 0.0081 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

9.  Percentage of antenatal corticotherapy Antenatal exposure at corticosteroids No of pregnancies % YES10748,9% NO11251,1% Total219100 % About 51 % of the women couldn’t get ACS

12. CORTICOTHERAPYMECHANICAL VENTILATION TOTAL YESNO YES9 42.9 % 43 69.4 % 52 62.7 % NO12 57.1 % 19 30.6 % 31 37.3 % TOTAL21 100 % 62 100 % 83 100 % P =0.03

13. CORTICOTHERAPYIVHTOTAL YESNO YES8 36.4 % 31 63.3 % 39 54.9% NO14 63.6 % 18 36.7 % 32 45.1 % TOTAL22 100 % 49 100 % 71 100% P= 0.03

14. CORTICOTHERAPYNo. of NEONATAL DEATHS TOTAL YESNO YES4 25 % 103 50.7 % 107 48.9% NO12 75 % 100 49.3 % 112 51.1% TOTAL16 100 % 203 100% 219 100 % P= 0.04

15.  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