Respiratory compliance in preterm infants after a single rescue course of antenatal steroids: a randomized controlled trial

Objective: To compare respiratory compliance and functional residual capacity in infants randomized to a rescue course of antenatal steroids vs placebo. Study Design: Randomized, double-blinded trial. Pregnant women ≥14 days after initial antenatal steroids were randomized to rescue antenatal steroids or placebo. The primary outcomes were measurements of respiratory compliance and functional residual capacity. This study is registered with clinicaltrials.gov (NCT00669383). Results: Forty-four mothers (56 infants) received rescue antenatal steroids and 41 mothers (57 infants) received placebo. There was no significant difference in birthweight, or head circumference. Infants in the rescue group had an increased respiratory compliance (1.21 vs 1.01 mL/cm H₂O/kg; adjusted 95% confidence interval, 0.01-0.49; P = .0433) compared with placebo. 13% in the rescue vs 29% in the placebo group required ≥30% oxygen (P < .05). Patients delivered at ≤34 weeks had greater pulmonary benefits. Conclusion: Infants randomized to rescue antenatal steroids have a significantly increased respiratory compliance compared with placebo.