Infant brain injury reduced by steroids


According to a US study, steroids given to pregnant women who risk giving birth prematurely have reduced cases of infant brain injury and improved babies' chances of survival.

Current guidelines recommend giving prenatal steroids to women at risk of delivering between the 24th and 34th weeks of pregnancy.

Premature baby – reduce risk of brain injury with steroids

"These findings provide strong evidence that prenatal steroids can benefit infants born as early as the 23rd week of pregnancy," said study author Dr Rosemary Higgins of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

The study, published in the Journal of the American Medical Association, was conducted by researchers participating in the NICHD Neo-natal Research Network and led by the University of Alabama.

Steroid hormones given to pregnant woman who risk premature delivery aid maturity of the foetus' lungs. For infants born prematurely, increased lung development improves survival chances and could decrease the risk of brain injury.

Babies born as early as the 22nd to 25th week of pregnancy are the smallest and frailest of babies born prematurely.

Neil Fearn of Simpson Millar LLP noted that despite the best intensive care available, many die soon after birth. "Although some survive and reach adulthood with relatively little trouble, the rest will experience some degree of lifelong disability, including intellectual disability, cerebral palsy and minor hearing loss."

To conduct the study, hospital records were analysed for 10,541 infants born prematurely from 1993 to 2009. Researchers also performed neurological examinations on the 4,924 surviving infants born between 1993 and 2008, with examinations conducted 18-22 months after the infants' original due dates. All the babies were born between the 22nd and 25th weeks of pregnancy.

Researchers found 33% fewer deaths among infants born to mothers who received pre-natal steroids compared with those whose mothers did not. The team also found that of the infants who survived, hearing and blindness, cerebral palsy or severe delays in motor and cognitive development were over 20% lower in cases where mothers had received ante-natal steroids.

"These findings have important implications for the future of obstetrics," said Neil Fearn. "If the results of the study are confirmed, this should be reflected in changes to medical guidelines relating to premature birth and how best to avoid infant brain injury."

"Giving steroid hormones to pregnant woman at risk of giving birth premature may become as commonplace as the recently introduced protocol for induced hypothermia for premature infants believed to be suffering from hypoxic-ischemic encephalopathy - and hopefully just as efficient in reducing infant brain injury."

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