Islamabad: Steroids help preterm babies survive, AKU study reveals. Researchers from AKU Pakistan and from five countries in Asia and Africa in collaboration with the World Health Organization have concluded a clinical trial that shows that the use of antenatal steroids with accurate pregnancy dating and quality care for mother and baby dyad are key to survival of preterm babies. The trial has been published in one of the premier International journal NEJM.
Dexamethasone a corticosteroid when given to pregnant females at risk of preterm delivery can enhance the survival of premature babies in low-resource settings. This ground-breaking trial has put an end to controversies regarding safety and efficacy of the antenatal steroids and its impact on improved survival of preterm in low -income countries. Majority of the evidence on the benefits of Dexamethasone on preterm births was from studies conducted in high income countries where both access to care and quality of care is superior and advanced.
This trial is unique that it has for the first time provided scientific evidence on the benefits of dexamethasone for pregnant women at risk of preterm births in local district health systems in low resource countries .The clinical trail showed that the benefits are tremendous and for every 25 pregnant women treated with dexamethasone, one premature baby’s life was saved! The trial conducted from December 2017–November 2019, recruited 2852 women and their 3070 babies from 29 secondary and tertiary level hospitals in addition to Pakistan : Bangladesh, India, Kenya and Nigeria. Beyond finding a significantly lower risk of neonatal death and stillbirth, the study also found there was no increase in possible maternal bacterial infections when treating pregnant women with dexamethasone in low-resource settings.
Dexamethasone when given timely at least 48 hours prior to expected or planned delivery to the pregnant women, it crosses the placenta and accelerates lung maturity, hence improving the survival with less respiratory problems and hypoxia to the baby. The clinical trial also puts to rest the controversy generated by a previous trial where controversial findings were reported from less than optimal use in unregulated settings in the community.
Drs Shabina Ariff, Lumaan Sheikh and Sajid Soofi, investigators from Pakistan site articulated that if we could ensure administration of antenatal steroids, adequate resuscitation, infection prevention and management, nutrition support, thermal care and access to respiratory support with either oxygen, high-flow or CPAP machine in district health systems, many preterm lives could be saved.