Injection of corticosteroids into mother to prevent neonatal respiratory distress syndrome.

In this study, 500 mg. of hydrocortisone were injected intravenously into 126 women every 12 hours for four doses in a double-blind, randomized fashion. These 126 subjects were at risk for delivery of a premature infant because of premature labor of fetomaternal disease necessitating intervention. There were 67 patients in the treatment group and 59 in the placebo group. All patients had immature lecithin/sphingomyelin ratios and/or were at less than 34 weeks' gestation. From these data, it appeared that there was a significant decrease in respiratory distress syndrome when the treatment group was compared to the placebo group. The neonatal survival rates also were improved significantly by steroid treatment. There was no demonstrable adverse steroid effect in mothers of fetuses in the long-term or short-term follow-up period, although a significant number of patients were lost to follow-up and the methodology of infant evaluation was imprecise. It would appear from these data that the injection of steroids is beneficial in mothers at risk of being delivered of premature infants. However, many questions remain to be answered before this method can be relied upon as therapy for women with premature labor.