Pulmonary function and outcomes in infants randomized to a rescue course of antenatal steroids

Cynthia (Cindy) McEvoy, Diane Schilling, Patricia Spitale, Jean O'Malley, Susan Bowling, Manuel Durand

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background/Objective: Our objective was to obtain follow-up pulmonary function testing and assessment of clinical respiratory outcomes, at 1-2 years, in preterm infants whose mothers were randomized to a single rescue course of antenatal steroids (AS) versus placebo. Methods: Follow-up of a randomized, double-blinded trial. In the original trial pregnant women ≥14 days after initial course of AS were randomized to rescue AS or placebo. Pulmonary function testing and a standardized respiratory questionnaire were obtained at 1-2 years of corrected age. Respiratory compliance (Crs) was measured with the single-breath occlusion and functional residual capacity (FRC) with the nitrogen washout method. Analysis was by intention-to-treat. Results: A total of 96 (87%) of available survivors were administered a respiratory questionnaire. Seventy-seven percent of available patients had pulmonary function testing performed. There was no significant difference between groups in incidence of wheezing, asthma, respiratory syncytial virus infection, respiratory readmissions, use of bronchodilators or other medications, or in measurements of pulmonary function. There was also no significant difference in corrected age at study, race, gender, or length at the time of pulmonary function testing. Infants in the rescue group had a comparable mean FRC (249.4mL vs 246.2mL; adjusted 95%CI for difference -15.45, 38.20; P=0.37) versus placebo. There were no differences in tidal volume or Crs. Conclusion: A rescue course of AS significantly increases Crs within 72h of age and decreases oxygen need in newborn infants, without an adverse impact on pulmonary function or clinical respiratory outcomes at 1-2 years of age [NCT00669383].

Original languageEnglish (US)
JournalPediatric Pulmonology
DOIs
StateAccepted/In press - 2017

Fingerprint

Steroids
Lung
Functional Residual Capacity
Placebos
Respiratory Syncytial Virus Infections
Intention to Treat Analysis
Bronchodilator Agents
Tidal Volume
Respiratory Sounds
Premature Infants
Compliance
Survivors
Pregnant Women
Nitrogen
Asthma
Mothers
Newborn Infant
Oxygen
Incidence
Surveys and Questionnaires

Keywords

  • Betamethasone
  • Clinical respiratory outcomes
  • Functional residual capacity
  • Infant pulmonary function
  • Rescue antenatal corticosteroids
  • Respiratory compliance
  • Tidal volume

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pulmonary and Respiratory Medicine

Cite this

Pulmonary function and outcomes in infants randomized to a rescue course of antenatal steroids. / McEvoy, Cynthia (Cindy); Schilling, Diane; Spitale, Patricia; O'Malley, Jean; Bowling, Susan; Durand, Manuel.

In: Pediatric Pulmonology, 2017.

Research output: Contribution to journalArticle

McEvoy, Cynthia (Cindy) ; Schilling, Diane ; Spitale, Patricia ; O'Malley, Jean ; Bowling, Susan ; Durand, Manuel. / Pulmonary function and outcomes in infants randomized to a rescue course of antenatal steroids. In: Pediatric Pulmonology. 2017.
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abstract = "Background/Objective: Our objective was to obtain follow-up pulmonary function testing and assessment of clinical respiratory outcomes, at 1-2 years, in preterm infants whose mothers were randomized to a single rescue course of antenatal steroids (AS) versus placebo. Methods: Follow-up of a randomized, double-blinded trial. In the original trial pregnant women ≥14 days after initial course of AS were randomized to rescue AS or placebo. Pulmonary function testing and a standardized respiratory questionnaire were obtained at 1-2 years of corrected age. Respiratory compliance (Crs) was measured with the single-breath occlusion and functional residual capacity (FRC) with the nitrogen washout method. Analysis was by intention-to-treat. Results: A total of 96 (87{\%}) of available survivors were administered a respiratory questionnaire. Seventy-seven percent of available patients had pulmonary function testing performed. There was no significant difference between groups in incidence of wheezing, asthma, respiratory syncytial virus infection, respiratory readmissions, use of bronchodilators or other medications, or in measurements of pulmonary function. There was also no significant difference in corrected age at study, race, gender, or length at the time of pulmonary function testing. Infants in the rescue group had a comparable mean FRC (249.4mL vs 246.2mL; adjusted 95{\%}CI for difference -15.45, 38.20; P=0.37) versus placebo. There were no differences in tidal volume or Crs. Conclusion: A rescue course of AS significantly increases Crs within 72h of age and decreases oxygen need in newborn infants, without an adverse impact on pulmonary function or clinical respiratory outcomes at 1-2 years of age [NCT00669383].",
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