Summary
We investigated the effectiveness of antenatal glucocorticoid therapy for prevention of neonatal respiratory distress syndrome (RDS). 637 cases, born before 35+6 compl. weeks of gestation, birth weight 2500 g, were analysed retrospectively. No clear results could be obtained at the first attempt. Further subgrouping revealed those premature babies, who had a benefit of antenatal corticoid therapy: Eutrophic babies, born before 32+6 weeks of gestation developed RDS in 27% after steroid treatment, 52% if no therapy could be applied. Some other obstetrical factors play a role in the development of RDS: low 1′- and 5′-Apgar scores, premature rupture of membranes 24 h prior to delivery, mode of delivery and sex of the newborn. Following steroid therapy severe states of RDS occurred less frequently. Studies about alternatives to steroid therapy are still in an experimental stage but are quite promising in the future.
Zusammenfassung
Untersucht wurde die Wirksamkeit der Glucocorticoidtherapie zur Vermeidung des RDS von Frühgeborenen. Die retrospektive Analyse von 637 Fällen mit einem Geburtsgewicht 2500 g, geboren vor der 35+6 SSW zeigte zunächst kein eindeutges Ergebnis. Erst bei weiterer Aufteilung der Kolektive ergibt sich eine Gruppe von Frühgeborenen, die von der Glcocorticoidprophylaxe profitieren: Es sind dies eutrophe Kinder, die vor der 32+6 SSW geboren werden. Hier beträgt die Inzidenz des RDS 27% nach Glucocorticoidbehandlung, 52% ohne Therapie. Weitere geburtshilfliche Umsände mt, Einfluß auf das Entstehen eines Atemnotsyndroms: niedrige 1′ und 5′ Apgar-Scores, vorzeitiger Blasenprung 24 h vor Geburt, Geburtsmodus und Geschlecht des Kindes nach Kortikoidgabe sind schwere Formen des RDS signifikant seltener. Alternative zur Kortikoidtherapie befinden sich noch im experimentellen Stadium, sollen aber intensiv untersucht werden.
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Lorenz, U. Experimentelle und klinische Ergebnisse der fetalen Lungenreifebehandlung. Arch Gynecol Obstet 245, 70–75 (1989). https://doi.org/10.1007/BF02417176
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DOI: https://doi.org/10.1007/BF02417176