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Page 37
Volume 5
Journal of Pediatric Care
ISSN: 2471-805X
JOINT EVENT
Neonatology 2019
Pediatrics Surgery 2019
April 23-24, 2019
April 23-24, 2019 London, UK
&
23
rd
Edition of International Conference on
Neonatology and Perinatology
4
th
International Conference on
Pediatrics and Pediatric Surgery
Antenatal steroids-Where are we?
Bikash Shrestha
Nepalese Army Institute of Health Sciences, Nepal
E
arly steroids studies in fifties and sixties involved animals and the effects they had upon various organs. It was not
until in 1969 when GC Liggins, while studying the effects of steroids upon the initiation of labor in fetal lambs,
that he noticed the steroids treated lambs not only had initiation of labor but they also had relatively more mature
lungs and better survival. This further led to studies which directly showed the effect of steroids upon maturing lungs
by accelerated surfactant appearance. In 1972, landmark study by GC Liggins and RN Howie showed that steroids
could reduce the incidence of RDS in preterm neonates. This study led pathway to numerous studies all over the
world showing effects of steroids in maturation of lungs. However, they also showed caution regarding the potential
adverse effects. In 1990, systemic review by P Crowley clearly showed the beneficial effects of steroids in reduction of
RDS with minimal adverse effects. Further in 1994, consensus statement by NIH gave the current recommendation
and regimen for antenatal steroids for preterm deliveries. Further consolidation of the positive effects of steroids was
done by meta-analysis by D Roberts in 2000 and further in 2006. However, despite clear evidence of beneficial effects,
2014 study in Lancet showed that the use of corticosteroids in lower income countries like Nepal, Afghanistan,
Niger and Congo was low. The use of antenatal steroids must be encouraged especially in lower income countries for
reducing the neonatal mortality rates in these countries.
kalmaan@yahoo.comJ Pediatr Care 2019, Volume 5
DOI: 10.21767/2471-805X-C1-021