Clinical reviews
← vista completaPublished on October 8, 2015 | http://doi.org/10.5867/medwave.2015.09.6280
Do antenatal corticosteroids in term elective cesarean sections reduce neonatal respiratory morbidity?
El uso de corticoides antenatales en cesáreas electivas de término, ¿reduce la morbilidad respiratoria?
Abstract
INTRODUCTION Neonatal respiratory distress syndrome is closely related to gestational age and mode of birth. Lowest gestational ages and caesarean section are associated with higher risk of developing respiratory distress syndrome. The efficacy of antenatal corticosteroids is well established in the induction of lung maturation in premature births. Its use could be a beneficial intervention in term fetuses that will be born by elective caesarean section.
OBJECTIVE To find the best evidence available to determine whether the use of antenatal corticosteroids reduces the incidence of respiratory distress syndrome in term babies born by elective caesarean section.
METHODOLOGY We searched the available medical literature in different databases: PubMed, LILACS, UpToDate, Trip database, Scielo and Cochrane. We considered controlled, randomized therapeutic studies, performed on humans, in which the intervention included corticosteroids as a treatment in elective term cesareans.
RESULTS We selected two studies. In both, the intervention was two doses of 12 mg of dexamethasone before the caesarean section. The primary objective in both studies was to analyze the incidence of respiratory distress syndrome and the admission of the newborn into intensive care units. In both studies, there was less incidence of neonatal respiratory distress syndrome, with statistically significant results.
CONCLUSIONS We concluded that the use of corticosteroids in elective term caesarean section reduces the incidence of neonatal respiratory distress syndrome and the admission into intensive care units. However, we evidenced certain weaknesses that could modify the internal validity of both studies, so it is necessary to develop new studies that could support these findings in order to modify clinical protocols in term elective caesarean sections.
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