An analysis of the factors associated with respiratory distress syndrome in premature infants whose mothers had been given dexamethasone therapy.

The incidence of respiratory distress syndrome (RDS) in 259 premature infants whose 218 mothers had received antepartum dexamethasone therapy was 8.9 per cent. The main characteristics of those infants who developed RDS were a shorter gestational age and a lower Apgar score at delivery; all were delivered before 35 weeks gestation, and those with Apgar scores below 7 had a significantly higher incidence of RDS. The incidence of RDS in vaginal breech deliveries (15.4 per cent), Caesarean sections (14.6 per cent), and multiple births (16.0 per cent) was higher than in vaginal vertex deliveries (6.8 percent), and in singletons (6.0 per cent). The use of isoxsuprine and the length of time membranes were ruptured before delivery were unrelated to the incidence of RDS. The results of this study suggest that while maternal glucocorticoid administratioin is an important ancillary to the prevention of RDS in premature infants it cannot substitute for optimal delivery conditions.