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Particularly when an infant is born before 36 weeks'
gestation, the premature infant's lungs are immature,
and the body has limited muscle strength and energy for breathing. So the
premature infant may not get enough oxygen. This can
cause serious medical complications. It is common at birth for a premature
infant to need
oxygen therapy, a
ventilator, and/or medicine to help with oxygen
absorption and breathing.
Infants whose lungs have been quickly
matured with corticosteroid treatment before birth
(antenatal corticosteroids, given by injection to the mother) have
a lot fewer medical complications than those who are not treated.
Infants with underdeveloped lungs often lack surfactant, a substance that coats the airways, preventing
them from collapsing and sticking together. When premature lungs are treated
with surfactant after birth, the infant's blood oxygen levels usually improve
within minutes. Surfactant treatment reduces the risk and the severity of
respiratory distress syndrome (RDS) in premature
infants as well as the overall risk of death.1
Surfactant also helps treat RDS.
Unlike corticosteroid treatment
before birth, giving corticosteroids to a baby after birth (postnatal) is losing favor in the medical community. Current
research is focusing on how this medicine can be safely used to improve lung
function without causing neurological deficits, gastrointestinal bleeding and
damage, blood sugar problems, and high blood pressure.
Cunningham FG, et al. (2010). Diseases and injuries of the fetus and newborn. In Williams Obstetrics, 23rd ed., pp. 605–643. New York: McGraw-Hill.
Other Works Consulted
Engle WA, Committee on Fetus and Newborn (2008). Surfactant-replacement therapy for respiratory distress in the preterm and term neonate. Pediatrics, 121(2): 419–432.
Soll R, Özek E (2010). Prophylactic protein free synthetic surfactant for preventing morbidity and mortality in preterm infants. Cochrane Database of Systematic Reviews (1).
March 22, 2013
Sarah Marshall, MD - Family Medicine & Kimberly Dow, MD, FRCPC - Neonatology
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