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September 1976

Use of Prenatal Glucocorticoid Therapy to Prevent Respiratory Distress Syndrome: A Supporting View

Author Affiliations

From the Department of Pediatrics, Mount Zion Hospital (Dr R. Ballard), and the Department of Pediatrics and the Specialized Center of Research in Pulmonary Diseases of the Cardiovascular Research Institute, University of California, San Francisco (Dr P. Ballard).

Am J Dis Child. 1976;130(9):982-987. doi:10.1001/archpedi.1976.02120100072011

In spite of recent major advances in the care of infants with neonatal respiratory distress syndrome (RDS), this disease continues to extract a great economic and emotional cost. Infants with RDS require sophisticated care for long periods of time, experience substantial morbidity, and may have long term sequelae from the disease or its therapy. However, it now appears that the incidence of RDS can be appreciably lowered by the use of prenatal glucocorticoid therapy in appropriate circumstances. In this commentary, we will review the history, effectiveness, safety, and probable mechanism of glucocorticoids in the acceleration of fetal lung maturation.

Glucocorticoid Effects in Animals  In 1969, Liggins1 noted that a lamb born prematurely at 123 days (term is 150 days) after infusion of glucocorticoids was unexpectedly viable; it was postulated that corticosteroid treatment was inducing lung maturation and causing the appearance of surface active material (SAM) in alveolar spaces. Subsequent

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