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Additional Steroid Dose May Help Preemies
Date:1/29/2009

tion and smaller head circumferences in the babies.

"Then the pendulum swung the other way, and doctors were holding out on giving the first dose" until they were sure the woman was going to deliver, Kurtzman explained. That resulted in some women never getting treated before delivery.

"So, we developed this study for patients that remained pregnant for more than two weeks after receiving their first course," he said.

The study included 437 women from 18 medical facilities -- both community hospitals and academic medical centers. The women were randomly assigned to receive either a second, so-called "rescue," dose of steroids closer to delivery or a placebo.

The researchers found a significant reduction in respiratory problems for babies who received the second dose of steroids. Plus, they found no evidence of growth restriction or smaller head circumferences.

"We try to do the best we can to predict who's going to deliver early, but it's not always possible," Kurtzman said. "This information allows us to be a little bit less concerned about the timing of the first course, and that has a tremendously positive impact."

Dr. Peter Bernstein, a maternal-fetal medicine specialist at Montefiore Medical Center in New York City, said that premature birth is "one of our top problems" in obstetrics. "It's the second leading cause of neonatal mortality in the U.S.," he said. "This study shows we're continuing to chip away at this problem, and we're doing better."

More information

The March of Dimes has advice for expectant moms on preventing premature birth.



SOURCES: James Kurtzman, M.D., associate clinical professor, division of maternal-fetal medicine, department of obstetrics and gynecology, University of California, Irvine, and maternal-fetal medicine attending a
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