Particularly when an infant is born before 36 weeks'
gestation, the 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 health problems. It is common at birth for a premature
infant to need
oxygen therapy, a
ventilator, and/or medicine. These can help the baby absorb oxygen and breathe.
Infants whose lungs have been quickly
matured with corticosteroid treatment before birth have
a lot fewer problems than those who are not treated. With this treatment, the mother gets a series of shots of corticosteroids before she gives birth.
Infants with underdeveloped lungs often lack surfactant. This is a substance that coats the airways and prevents 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. It also reduces the overall risk of death.footnote 1
Surfactant also helps treat RDS.
Unlike corticosteroid treatment
before birth, giving corticosteroids to a baby after birth is losing favor among experts. Current
research is looking at how this medicine can be safely used to improve lung
function without causing other problems. (It can cause neurological problems, 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).
ByHealthwise Staff Primary Medical ReviewerSarah Marshall, MD - Family Medicine Kathleen Romito, MD - Family Medicine John Pope, MD - Pediatrics Specialist Medical ReviewerJennifer Merchant, MD - Neonatal-Perinatal Medicine
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