Health
Steroids help premature infants survive in countries like India: WHO newkerala.com # 187551
Geneva, October 25: Prenatal steroids such as dexamethasone, used to treat rheumatic problems and many other symptoms, including severe Covid-19, are given to pregnant women at risk of preterm birth in countries such as India. Researchers say it can increase the survival rate of premature babies at the World Health Organization (WHO). Dexamethasone and similar drugs have long been shown to be effective in saving the lives of preterm infants in high-income countries where quality neonatal care is more accessible.
This is the first clinical trial to prove that the drug is effective in low-income environments, according to a study published in The New England Journal of Medicine.
The WHO ACTION-I trial resolves the ongoing controversy over the effectiveness of prenatal steroids in improving the survival of preterm infants in low-income countries.
A randomized trial conducted from December 2017 to November 2019 enrolled 2852 women and 3,070 babies from 29 secondary and tertiary level hospitals in Bangladesh, India, Kenya, Nigeria and Pakistan. I did.
Not only did the study find that the risk of neonatal death and stillbirth was significantly lower, but also found that treatment of pregnant women with dexamethasone in a low-resource environment did not increase the likelihood of maternal bacterial infection. I did.
“Dexamethasone is now a proven drug to help babies born too early in a low-income environment,” said research author Dr. Orphemioradapo, who is responsible for the WHO’s maternal and perinatal health unit. Stated.
“But it is only effective if managed by a healthcare provider who can make timely and accurate decisions and provide a minimal package of quality care for both pregnant women and their babies,” Oladapo said. Added.
The impact was significant for every 25 pregnant women treated with dexamethasone, saving the life of one premature baby.
When given to mothers at risk of preterm birth, dexamethasone crosses the placenta and promotes lung development, reducing the likelihood that preterm infants will have respiratory problems at birth.
The study noted that healthcare providers need to select women who are most likely to benefit from the drug and have the means to start treatment correctly at the right time. Ideally, 48 hours before childbirth to give enough time to complete the steroid injection for maximum effect.
Women between the 26th and 34th weeks of gestation are most likely to benefit from steroids, so healthcare providers need to be able to use ultrasound to date the exact date of pregnancy.
In addition, babies must receive adequate quality care at birth, the team said.
“If minimal neonatal care packages are in place in low-income countries, prenatal steroids such as dexamethasone can help save the lives of premature babies,” said a study head of the WHO Neonatal Health Unit. The author, Dr. Rajivbar, said.
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