PRENATAL CORTICOSTEROID TREATMENT AND ACC ELERATED FETAL PULMONARY MATURATION .2. RESULTS OF CLINICAL-STUDIES

Numerous subsequent controlled trials and recent meta-analysis have co nfirmed the efficiency of antenatal glucocorticoid therapy in reducing both the incidence of respiratory distress syndrome (RDS) and perinat al mortality. Moreover, antenatal glucocorticoid administration reduce s the odds of several severe complications relating to immaturity: int raventricular hemorrhage (IVH), ductus arteriosus patency, necrotising enterocolitis, and hemodynamic failure. Exogenous surfactant therapy has not ruled out the benefits of corticosteroids: on the contrary, a synergic effect is obtained when both antenatal and postnatal therapeu tic approachs are combined. Very premature infants may also rake advan tage of the hormonal treatment: in this population, RDS occurence, IVH incidence and perinatal mortality are also reduced. Unfortunately, de spite convincing evidence, the incidence of antenatal steroids therapy has not yet achieved the optimal and desirable level. Obstetricians a nd pediatricians must be encouraged to ensure high maternal exposure t o steroids when preterm delivery is likely to occur.