Posted September 21, 200915 yr i wonder always about the use of steroids in peripartum period about it's side effects and effects. 1. When antenatal steroids are harmless and help in reducing RDS how post natal steroids have become dangerous in RDS ? 2.When steroids are used for BPD without serious consequences how the same steroid is dangerous if used post natally for RDS ? I will be happy to get the right answers for this nagging questions. thanks selvan rathinasmy ERODE,INDIA
September 22, 200915 yr A nice look at the concept behind the harmful effect of post natal steroids ( is it steroids or the sulphite ??? which is the culprit) Postnatal steroid treatment and brain development.Arch Dis Child Fetal Neonatal Ed 2004;89:F96–F100. doi: 10.1136/adc.2003.028696 FREE LINK Nice reviews of current knowledge regarding antenatal steroid use Antenatal corticosteroid treatment: what's happened since Drs Liggins and Howie? Bonanno C, Wapner RJ. Am J Obstet Gynecol. 2009 Apr;200(4):448-57. LINK Single versus repeat courses of antenatal steroids to improve neonatal outcomes: risks and benefits. Bonanno C, Fuchs K, Wapner RJ. Obstet Gynecol Surv. 2007 Apr;62(4):261-71. Review. LINK Antenatal steroid use may also have deleterious neurological /behavioural effect on the baby when multiple doses are given Leung, Tse N., Lam, Po M., Ng, Pak C. and Lau, Tze K.(2003)'Repeated courses of antenatal corticosteroids: Is it justified?',Acta Obstetricia et Gynecologica Scandinavica,82:7,589 — 596 LINK Repeated antenatal corticosteroids: effects on cerebral palsy and childhood behavior. French NP, Hagan R, Evans SF, Mullan A, Newnham JP. Am J Obstet Gynecol. 2004 Mar;190(3):588-95. LINK Two-year infant neurodevelopmental outcome after single or multiple antenatal courses of corticosteroids to prevent complications of prematurity. Spinillo A, Viazzo F, Colleoni R, Chiara A, Maria Cerbo R, Fazzi E. Am J Obstet Gynecol. 2004 Jul;191(1):217-24. LINK Long-term outcomes after repeat doses of antenatal corticosteroids. Wapner RJ, Sorokin Y, Mele L, Johnson F, Dudley DJ, Spong CY, Peaceman AM, Leveno KJ, Malone F, Caritis SN, Mercer B, Harper M, Rouse DJ, Thorp JM, Ramin S, Carpenter MW, Gabbe SG; National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. N Engl J Med. 2007 Sep 20;357(12):1190-8. FREE LINK Adverse neonatal outcomes associated with antenatal dexamethasone versus antenatal betamethasone. Lee BH, Stoll BJ, McDonald SA, Higgins RD; National Institute of Child Health and Human Development Neonatal Research Network. Pediatrics. 2006 May;117(5):1503-10. FREE LINK One thing that I can guarantee you selvan, is that after you read all these reviews/articles, you will end up having more nagging questions than when you had started !!
September 22, 200915 yr Author thanks a lot Jack! i will be back after reading through the articles selvan
September 24, 200915 yr Author i found out a cochrane review which supports antenatal steroids; http://www.cochrane.org/reviews/CD004454.pdf
September 24, 200915 yr Single dose of antenatal steroids is safe but the problem comes when multiple/repeated doses/courses of antenatal steroids are given
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