Steroids for premmie babies
Saw this on Syd Morning Herald site. (Wasn't sure whether to put this here or in News, events etc.. feel free to move it!)
:
Premature baby drug a dilemma for parents
Julie Robotham, Medical Editor
June 10, 2006
MULTIPLE steroid injections in pregnant women dramatically improve the chance a premature baby will be born with healthy lungs, Australian research has shown decisively for the first time.
But the same jabs might affect the developing brain and increase the risk of emotional and behavioural problems later.
Parents-to-be who had warning their baby might be premature would be put under tremendous pressure as they tried to reconcile the benefits and the risks of the practice, said Caroline Crowther, the Adelaide obstetrician who led the study, of 982 women, that produced the new findings. "It's always very difficult to deal with it. The sensitivities are really very large," she said.
But, said Professor Crowther, of the Women's and Children's Hospital, "the information's available and it would be wrong not to share that with families".
The study in 23 maternity wards in Australia and New Zealand found babies whose mothers received two or more courses of the steroid betamethasone were 18 per cent less likely to develop respiratory distress syndrome and 40 per cent less likely to have severe lung disease. They also needed less oxygen and mechanical ventilation than those whose mothers received a single steroid course. For every 14 women treated with the multiple shots, one baby avoided lung complications.
Reporting on her survey in The Lancet yesterday, Professor Crowther wrote the results "provide strong evidence for recommendation of the use of repeat doses of corticosteroids in women who remain at risk of very preterm birth."
She said lung problems remained the largest cause of death in the approximately 6500 babies each year born at less than 34 weeks of pregnancy.
Professor Crowther said that although the babies whose mothers had repeat injections weighed slightly less and had smaller head circumferences at birth, this difference had disappeared by the time the infants left hospital. She had begun collating measurements and developmental test results on the children at two years of age.
However, John Newnham, the head of the School of Women's and Infants' Health at the University of Western Australia, said the study did not justify the repeat use of steroids, and the children's smaller head size was particularly worrying.
"The question about repeat doses is not about the lungs, it's about the brain," said Professor Newnham, since ventilation techniques and lung protection drugs given after birth had improved. "For me any effect on brain development is the overriding issue … head circumference is a measure of brain growth. The biggest issue is [whether] these children have altered behaviour at three or six years old."
Professor Newnham's research in the late 1990s linking childhood behavioural problems to prebirth steroid exposure and showing steroid injections altered brain development in sheep led to the virtual abandonment of previously routine multiple steroid doses.
I wasn't faced with this decision, as Tallon wasn't that early.. but I hadn't really thought about the risks of using the steroids.. I just assumed it was best for bubs so they could breathe! Anyone looked into the post-birth alternatives?
What a scary decision tho!
