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December 07, 2011

Steroids Reduce Mortality by 33 Per Cent in Preemie Babies as Young as 22 Weeks at a cost of $50

With chubby cheeks and weighing in at a healthy 10 pounds, the imminently huggable Lexi Morrison is far removed from the 1-pound, 9 –ounce preemie she was in June when she was born premature at 24 weeks.

Giving antenatal corticosteroids in extremely preterm infants like Lexi — those born between 22 and 25 weeks gestation and weighing less than 2 pounds — is associated with significant reductions in death and long-term complications such as neurodevelopmental impairments, including cerebral palsy, poor motor skills and lower intelligence, according to research by Wally Carlo, M.D., director of the UAB Division of Neonatology, published in the Dec. 7, 2011, issue of the Journal of the American Medical Association.




Freeman knew she was at risk for premature labor; doctors placed a stitch in her cervix to keep it closed when she was 20 weeks pregnant, and she immediately went to the hospital when she began bleeding at 23 weeks. Several days later, at 24 weeks and two days, Lexi was born.

“I had problems before, and I lost a premature baby. I didn’t want it to happen again,” Freeman says. “They asked me if I wanted to use the steroids and I told them yes — whatever is better for Lexi I want to do it. They got two (doses) in me before she was born.”

Antenatal corticosteroids, when given to a woman in preterm labor, mature the lungs and other organs in the baby’s body. Two shots of the steroids have been recommended for women in premature labor as early as 24 weeks, but there were no data for 23 weeks or earlier gestation from randomized, controlled trials, Carlo says. And the data was quite limited in trials for pregnancies between 24 and 25 weeks.

“The results of the study showed that mortality was decreased by more than 33 percent and neurodevelopmental impairment was decreased by more than 20 percent,” Carlo says. “It seems that extremely premature infants, from 22 to 25 weeks, can respond as well as infants that are more mature. We also found that using the antenatal corticosteroids did not increase the infection rate for the mothers.”

Carlo says the study is important because it shows that a low-cost intervention, about $25 for two shots, gives even the earliest preemies a chance to survive and thrive.

Steroids increase viability of preemies as young as 22 weeks from uabnews on Vimeo.


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