Beneficial effects of the combined use of prenatal corticosteroids and postnatal surfactant on preterm infants.

OBJECTIVE: Our objective was to test the hypothesis that prenatal maternal corticosteroids would improve the subsequent response of infants to surfactant treatments. STUDY DESIGN: We used the data bases of two recently published large multicenter trials of multidose surfactant treatments to retrospectively evaluate the possible interactions between maternal corticosteroids and randomized surfactant treatments on short-term ventilatory effects, complications of respiratory distress syndrome and prematurity, and 28-day death rates. RESULTS: The combined use of corticosteroids and surfactant significantly decreased overall death and death caused by respiratory distress syndrome relative to either treatment alone. Ventilatory variables at 72 hours were improved in those infants receiving both treatments, and other major complications of prematurity also tended to have decreased incidences. CONCLUSION: The combined use of prenatal corticosteroids, when indicated, and postnatal surfactant improves neonatal outcome.