Objective
To estimate the effect of antenatal glucocorticoid administration on fetal lung maturity
in pregnancies with known fetal lung immaturity between the 34th and 37th weeks of
gestation.
Study Design
Pregnancies between 340/7 and 366/7 weeks undergoing amniocentesis to determine fetal lung maturity were targeted. Women
with negative results (TDx-FLM-II <45 mg/g) were randomly assigned to intramuscular
glucocorticoid injection or no treatment. A repeat TDx-FLM-II test was obtained 1
week after enrollment.
Results
Thirty-two women who met inclusion criteria were randomly assigned. Seven women delivered
within a week of testing for fetal lung maturity, and were excluded from the analysis.
Ten received glucocorticoid and 15 did not. Women assigned to glucocorticoids had
a mean increase TDx-FLM-II in 1 week of 28.37 mg/g. Women assigned to no-treatment
had an increase of 9.76 mg/g (P < .002).
Conclusion
A single course of intramuscular glucocorticoids after 34 weeks in pregnancies with
documented fetal lung immaturity significantly increases TDx- FLM-II.
Key words
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References
- Annual summary of vital statistics: 2006.Pediatrics. 2008; 121: 788-801
- Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.Cochrane database of systematic reviews (Online). 2006; 3 (CD004454)
- ACOG committee opinion no. 402: antenatal corticosteroid therapy for fetal maturation.Obstet Gynecol. 2008; 111: 805-807
- Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994.Am J Obstet Gynecol. 1995; 173: 322-335
- Neonatal morbidity according to gestational age and birth weight from five tertiary care centers in the United States, 1983 through 1986.Am J Obstet Gynecol. 1992; 166 (discussion 41-5): 1629-1641
- ACOG committee opinion no. 404 April 2008.Obstet Gynecol. 2008; 111: 1029-1032
- ACOG practice bulletin no. 97.Obstet Gynecol. 2008; 112: 717-726
- The mean weekly increment of amniotic fluid TDx-FLM II ratio is constant during the latter part of pregnancy.Am J Obstet Gynecol. 2005; 193: 1685-1690
- Diagnosis of the respiratory distress syndrome by amniocentesis.Am J Obstet Gynecol. 1995; 173 (1971) (discussion 30): 629
- Fetal maturity testing.Clin Obstet Gynecol. 1987; 30: 985-991
- Lamellar body counts for rapid fetal lung maturity testing.Obstet Gynecol. 1993; 81: 619-624
- Amniotic fluid lamellar body count: cost-effective screening for fetal lung maturity.Obstet Gynecol. 1999; 93: 387-391
- A comparison of the accuracy of the TDx-FLM assay, lecithin-sphingomyelin ratio, and phosphatidylglycerol in the prediction of neonatal respiratory distress syndrome.Obstet Gynecol. 1993; 82: 1004-1008
- Assessment of the diagnostic accuracy of the TDx-FLM II to predict fetal lung maturity.Clin Chemistry. 2002; 48: 761-765
- A comparison of amniotic fluid fetal pulmonary phospholipids in normal and diabetic pregnancy.Am J Obstet Gynecol. 2002; 186: 641-650
- Association between maternal diabetes and the respiratory-distress syndrome in the newborn.N Engl J Med. 1976; 294: 357-360
- The lung profile: II, complicated pregnancy.Am J Obstet Gynecol. 1979; 135: 64-70
Article info
Publication history
Published online: May 17, 2010
Accepted:
February 15,
2010
Received in revised form:
December 13,
2009
Received:
October 14,
2009
Footnotes
Dr Allsworth was supported in part by a Clinical and Translational Science Award (UL1RR024992) and by Grant no. KL2RR024994 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH) and NIH Roadmap for Medical Research.
Reprints not available from the authors.
The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH.
Cite this article as: Shanks A, Gross G, Shim T, et al. Administration of steroids after 34 weeks of gestation enhances fetal lung maturity profiles. Am J Obstet Gynecol 2010;203:47.e1-5.
Identification
Copyright
© 2010 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
