Premature babies who receive steroids before birth benefit from a positive side effect of the treatment, a new Stanford study confirms. For decades, pregnant women who are likely to deliver early have been receiving steroids to mature the baby's lungs and make breathing easier after birth.
But it turns out preemies' brains are helped by steroids, too. The new study, published today in the Journal of Perinatology, showed that preemies who received steroids before birth were half as likely as those who didn't to have a severe intraventricular hemorrhage, in which bleeding occurs into the spaces in the brain where cerebrospinal fluid usually circulates.
The association between prenatal steroids and lower hemorrhage risk had been noted before. But the new study examined an unusually large group of preemies — nearly 26,000 babies who were born prematurely between 2007 and 2013 — who were drawn from a statewide California database and whose outcomes allowed doctors to check whether the association held in the context of modern neonatal medicine, said senior author Henry Lee, MD. Lee, a neonatologist at Lucile Packard Children's Hospital Stanford, says the new data strengthens the evidence base for how best to care for these fragile babies. From our press release:
The rate of intraventricular hemorrhage in premature babies has declined since the 1980s, Lee noted. “That change is probably not due to only one thing, but more to our overall awareness of how to take better care of the baby before and after birth,” he said. For example, in addition to using prenatal steroids more often, doctors and nurses also keep premature babies’ heads in a stable position during the first few days of life, and attempt to avoid dramatic shifts in preemies’ blood pressure.
“It’s helpful to know that prenatal steroids are an impactful component to our strategy to prevent these potentially devastating hemorrhages,” Lee said. He thinks the new finding will be welcome news not just for other physicians but also for the parents of preemies.
“When I talk with these parents, I’m often describing risks and potential complications for their baby,” he said. “It helps to be able to talk not just about risks but also about proven therapies — to say, ‘Here is a therapy that we have found to be very beneficial.’”
Previously: Increasing number of hospitals offer breast milk to preemies, Rare gene variants help explain preemies' lung disease, Stanford study shows and Study of outcomes for early preemies highlights complex choices for families and doctors
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