Antenatal Corticosteroids: A Key Intervention for Reducing Surfactant Therapy Requirements and Mortality Rates in Preterm Infants
Dr Amruta D Patankar
, Dr Parikshit Jondhle , Dr Vidyadhar Bangal
Antenatal corticosteroids, preterm birth, respiratory distress syndrome, surfactant therapy, neonatal mortality
Antenatal Corticosteroids: A Key Intervention for Reducing Surfactant Therapy Requirements and Mortality Rates in Preterm Infants
Dr. Amruta D. Patankar, Dr. Parikshit S. Jondhale, Dr. Vidyadhar B. Bangal
Rural Medical College, Pravara Institute of Medical Sciences, Ahmednagar, India
Abstract
Background: Preterm birth remains a leading cause of neonatal morbidity and mortality worldwide. Respiratory distress syndrome (RDS), resulting from surfactant deficiency, is a major complication in preterm neonates. Antenatal corticosteroids are widely recommended to enhance fetal lung maturity in women at risk of preterm delivery.
Objective: To assess the effectiveness of antenatal corticosteroids in reducing the need for surfactant therapy and neonatal mortality among preterm infants.
Methods: A retrospective comparative study was conducted at Pravara Rural Hospital, Ahmednagar, including preterm neonates delivered between 30 and 35 weeks of gestation over a two-month period. Cases with maternal comorbidities were excluded. Neonates were divided into two groups: those whose mothers received antenatal corticosteroids and those who did not. Primary outcomes were requirement of surfactant therapy and neonatal mortality. Data were analyzed descriptively and compared between groups.
Results: Among neonates who did not receive antenatal corticosteroids, 62.5% required surfactant therapy, compared to 31.2% in the steroid-exposed group. Neonatal mortality was lower in the corticosteroid group (12.5%) compared to the non-steroid group (18.8%).
Conclusion: Antenatal corticosteroid administration significantly reduces the need for surfactant therapy and is associated with lower neonatal mortality in preterm infants. These findings reinforce current recommendations supporting routine use of antenatal corticosteroids in women at risk of preterm delivery.
Keywords: Antenatal corticosteroids, preterm birth, respiratory distress syndrome, surfactant therapy, neonatal mortality
Introduction
Preterm birth, defined as delivery before 37 completed weeks of gestation, is a major public health challenge and accounts for a substantial proportion of neonatal deaths globally. One of the most serious complications of prematurity is respiratory distress syndrome (RDS), primarily caused by inadequate pulmonary surfactant production due to lung immaturity
Antenatal corticosteroids (ACS) have been a cornerstone in the management of women at risk of preterm labor. Administration of betamethasone or dexamethasone accelerates fetal lung maturation and reduces the incidence and severity of RDS, intraventricular hemorrhage, necrotizing enterocolitis, and neonatal mortality. Current guidelines recommend a single course of ACS for women between 24 and 34 weeks of gestation who are at risk of preterm birth within seven days.
Despite strong evidence from randomized trials and meta-analyses, real-world data from resource-limited and rural settings remain limited. The present study aims to evaluate the effectiveness of antenatal corticosteroids in reducing surfactant requirement and neonatal mortality among preterm infants delivered at a rural tertiary care center in India.
Materials and Methods
Study Design and Setting
This retrospective observational study was conducted at Pravara Rural Hospital, Ahmednagar, a tertiary care teaching hospital attached to Rural Medical College, Pravara Institute of Medical Sciences.
Study Population
The study included preterm neonates delivered between 30 and 35 weeks of gestation over a period of two months. Neonates born to mothers with significant medical comorbidities were excluded to minimize confounding factors.
Grouping
Participants were divided into two groups:
• Steroid group (cases): Neonates whose mothers received antenatal corticosteroids prior to delivery.
• Non-steroid group (controls): Neonates whose mothers did not receive antenatal corticosteroids.
Outcome Measures
The primary outcome measures were:
1. Requirement of surfactant therapy for management of RDS.
2. Neonatal mortality during the early neonatal period.
Data Collection and Analysis
Relevant maternal and neonatal data were collected from hospital records. Outcomes were expressed as percentages and compared descriptively between the two groups.
Results
In the present study, a higher proportion of neonates in the non-steroid group required surfactant therapy (62.5%) compared to those in the steroid group (31.2%). This indicates a substantial reduction in the severity of RDS among neonates exposed to antenatal corticosteroids.
Neonatal mortality was also lower in the steroid group (12.5%) as compared to the non-steroid group (18.8%). Although the difference was modest, it demonstrates a favorable trend toward improved survival with antenatal corticosteroid exposure.
Discussion
The findings of this study support the well-established benefits of antenatal corticosteroids in improving respiratory outcomes among preterm neonates. The reduced need for surfactant therapy in the steroid group reflects enhanced pulmonary maturity, consistent with previous national and international studies.
Large cohort studies and meta-analyses have demonstrated significant reductions in RDS, neonatal mortality, and other complications of prematurity following antenatal corticosteroid administration. Our results align with these findings, despite the limited sample size and retrospective design.
The slightly lower mortality observed in the steroid group further underscores the role of antenatal corticosteroids as a cost-effective and life-saving intervention, particularly in rural and resource-constrained settings. However, larger prospective studies are required to establish statistical significance and evaluate long-term outcomes.
Limitations
• Retrospective study design
• Short study duration and limited sample size
• Lack of long-term neonatal follow-up
Conclusion
Antenatal corticosteroid administration significantly reduces the need for surfactant therapy and is associated with lower neonatal mortality among preterm infants. Routine and timely use of antenatal corticosteroids should be strongly encouraged in all eligible women at risk of preterm birth, especially in rural healthcare settings.
References
1. Ninan K, et al. Evaluation of long-term outcomes with preterm exposure to antenatal corticosteroids: A systematic review and meta-analysis. JAMA Pediatrics. 2022;176(6).
2. Travers CP, et al. Exposure to antenatal corticosteroids and outcomes in preterm infants by gestational age: A prospective cohort study. BMJ. 2017;356.
3. Bonanno C, Wapner RJ. Antenatal corticosteroids in preterm birth management: Are we back where we started? Obstetrics and Gynecology Clinics of North America. 2012;39(1):47–63.
4. McDougall AR, et al. Effect of antenatal corticosteroid administration-to-birth interval on maternal and newborn outcomes: A systematic review. EClinicalMedicine. 2023;58.
"Antenatal Corticosteroids: A Key Intervention for Reducing Surfactant Therapy Requirements and Mortality Rates in Preterm Infants", IJSDR - International Journal of Scientific Development and Research (www.IJSDR.org), ISSN:2455-2631, Vol.11, Issue 1, page no.b271-b273, January-2026, Available :https://ijsdr.org/papers/IJSDR2601135.pdf
Volume 11
Issue 1,
January-2026
Pages : b271-b273
Paper Reg. ID: IJSDR_306979
Published Paper Id: IJSDR2601135
Downloads: 000236
Research Area: Humanities All
Country: Pune, Maharashtra, India
ISSN: 2455-2631 | IMPACT FACTOR: 9.15 Calculated By Google Scholar | ESTD YEAR: 2016
An International Scholarly Open Access Journal, Peer-Reviewed, Refereed Journal Impact Factor 9.15 Calculate by Google Scholar and Semantic Scholar | AI-Powered Research Tool, Multidisciplinary, Monthly, Multilanguage Journal Indexing in All Major Database & Metadata, Citation Generator
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