Title: Effectiveness of Steroid Therapy in Newborns with Meconium Aspiration Syndrome
Authors: Dr Sangeetha.T, Dr Ramanathan.R, Dr Yogavalli.S
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.214
Abstract
Objective: Meconium aspiration syndrome (MAS) is one of the serious and life-threatening disorders in newborn infants and is still one of the most challenged neonatal diseases. This study was conducted in order to determine the efficacy of steroid use in the management of this syndrome.
Study Design & Period and Place of study: A prospective study of twelve months period in the neonatal intensive care unit was carried out at Rajah Muthiah Medical College & Hospital, Chidambaram.
Materials and Methods: We included Sixty (60) babies with MAS which were then distributed randomly into two groups i.e. Group A (n = 30), patients in this group served as controls and Group B (n = 30), patients who were treated with steroids served as study group. Injectable dexamethasone was administered @ 0.5mg/kg/dose q12h for the first 3 days & 0.25mg/kg/dose q-12-h for the next 4 days along with supportive treatment. Non steroid group received only supportive care (control group). Infants in present trial were evaluated on the basis of duration of stay at hospital, requirement of ventilatory support and occurrence of pneumothorax.
Results: We observed a statistically significant difference in the duration of stay between the two groups. There was also a difference in the requirement of ventilator support and occurrence of pneumothorax in the study, but it was not statistically significant.
Conclusion: The conclusion of our study is that steroids revealed shorter duration of stay, less ventilator requirement and less morbidity in newborns with MAS. Thus steroid therapy has a favourable effect on the outcome on MAS in newborn.
Keywords: Meconium aspiration syndrome, Newborn infants, Steroids.
References
1. Wiswell TE, Tuggle JM, Turner BS. Meconium aspiration syndrome: have we made a difference? Pediatrics. 1990;85(5): 715-21.
2. Ross MG. Meconium aspiration syndr-ome- more than intrapartum meconium. New Eng. J. Med. 2005;353:946-48.
3. Swarnam K, Soraisham AS, Sivanandan S. Advances in the Management of Meconium Aspiration Syndrome. Int. J. Ped. 2012;1:7.
4. Dargaville PA, Copnell B. The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapies and outcome. Pediatrics. 2006;117:1712–21.
5. Yoder BA, Kirsch EA, Barth Jr. WH, Gordon MC. Changing obstetric practices associated with decreasing incidence of meconium aspiration syndrome. Obstet Gynecol. 2002;99(5):731-9.
6. Qian L, Liu C, Zhuang W, et al. Neonatal respiratory failure: a 12-month clinical epidemiologic study from 2004 to 2005 in China. Pediatrics. 2008;121:1115-24.
7. Ward M, Sinn J. Steroid therapy for meconium aspiration syndrome in newborn infants. Cochrane Database of Systematic Reviews. 2003;4:251.
8. Basu S, Kumar A, Bhatia BD, Satya K, and Singh TB, “Role of steroids on the clinical course and outcome of meconium aspiration syndrome-a randomized contr-olled trial,” J. Tropi. Pediatr, 2007;53 (5):331-7.
9. Tripathi S and Saili A, “The effect of steroids on the clinical course and outcome of neonates with meconium aspiration syndrome,” J. Tropi. Pediatr, 2007;53 (1):8-12.
10. Mokra D, Mokry J. Glucocorticoids in the treatment of neonatal meconium aspiration syndrome. Eur J Pediatr. 2011;170(12): 1495-1505.
11. Barrington KJ. The adverse neurodevelopmental effects of post natal steroids in the preterm infant: a systemic review of RCTs. BMC Pediatr. 2001;1:1.
12. Laforce WR, Brudno DS. Controlled trial of beclomethasone dipropionate by nebu-lization in oxygen- and ventilator-depen-dent infants. J Pediatr. 1993;133: 285-8.
13. Barr P. The use of dexamethasone in full term infants with severe respiratory failure and pulmonary barotraumas.J Pediatr Child Health. 1991;27:366-9.
14. Naveed Akbar Hotiana, Sumaira Naveed, Asma Anwar, Rashid Mehmood A.P.M.C Vol: 9 No. 3 July-September 2015.