Efeitos do corticoide antenatal em prematuros de muito baixo peso

Abstract

Introduction: The benefits of antenatal corticosteroid (AC) to preterm infants are well established. Its action in multiple tissues promotes maturity of fetal structures, with significant impact in the reduction of neonatal morbimortality. Objective: Evaluate the effects of AC in very low birth weight preterm infants (VLBWPI). Methods: Data from the Rede Gaúcha de Neonatologia of those VLBWPI born between 01/01/2008 and 12/31/2014 at the Fêmina Hospital in Porto Alegre was used. The exposure to AC (one or two doses of intramuscular 12mg betamethasone) and its relation to mortality and following comorbidities were analyzed: respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA), and bronchopulmonary dysplasia (BPD). Results: A total of 496 patients were obtained, of whom 68% received at least one dose of CA and 32% received none. A significant reduction in the incidence of RDS was obtained in the group that exposed to AC (OR 0.468, p = 0.001). A 60% reduction in IVH (OR 0.401, p < 0.001) was noted. A reduction in the incidence of BPD was also observed with the use of AC (OR 0.296-0.903, p = 0.018). No statistical difference was observed in the incidence of PVL (p = 0.3), PDA (p = 0.68), NEC (p = 0.44) or ROP (p = 0.58). Neonatal death was significantly reduced by 78% in those treated with AC (OR 0.22, p < 0.001). Conclusion: exposure to AC, regardless of the number of doses, confers lower morbidity and lower mortality to VLBWPI. Palavras-chave: Doenças do Prematuro, Prematuro, Glucocorticoides, Recém-Nascido de muito Baixo Peso.