The influences of Corticosteroid to the neonatal complications with or without placental chorioamnionitis

In order to clarify the influences of corticosteroid to the neonatal complications, relationship between dexamethazone or betamethazone administration to the pregnant women before delivery and neonatal diseases, such as respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH) and perinatal death, was analized in 192 cases of premature delivery with or without placental chorioamnionitis (CAM) from 1989 to 1995. Each case was devided into three groups according to the gestational age, such as less than 28 weeks, 28-31 weeks and 32-33 weeks of gestation. CAM was diagnosed by the histopathological examination of the placenta after delivery, and 105 cases were diagnosed with CAM. Corticosteroid, dexamethazone (6 mg) every 6 hours for 48 hours or betamethazone (12 mg) every 12 hours for 48 hours, was injected intramuscularly to the mother in 88 cases. In the neonates from the mother with steroid treatment, death rate of premature infants at 22-27 weeks of gestation was significantly reduced (p = 0.020), and the incidence of IVH at 28-31 weeks was also significantly reduced (p=0.023) compared with those from without steroid treatment. However, there were no differences in the incidences of neonatal RDS at any gestational age. The incidence of neonatal RDS in placental CAM positive group at 28-31 weeks of gestation was significantly lower than the CAM negative group (p=0.014), while there was no statistical difference of the incidence of neonatal RDS between the CAM positive group and the CAM negative group at 22-27 or 32-33 weeks of gestation. These results suggest that steroid treatment to the mother before delivery reduces the neonatal complications in the neonates born at gestational ages between 22 and 31 weeks, and also placental CAM shows the favorable influences to the occurrence of RDS in the neonates at 28-31 weeks of gestation.