Clinicians and birth injury experts have long known that administering prenatal steroids to premature infants hastens lung maturation and improves outcomes, but recent research has uncovered some additional benefits for this at-risk population.
Dr. Henry Lee of Stanford University reports in the Journal of Perinatology (part of the prestigious Nature Publishing Group, which publishes some of the top scientific journals in the world) that a large-scale retrospective study demonstrated that giving prenatal steroids to mothers at risk of imminent preterm birth significantly decreased the risk of intraventricular hemorrhage (IVH) in their premature children.
Prenatal Steroids Reduce IVH Incidence:
The study showed that prenatal steroids administered to mothers before delivery of low-birthweight infants decreased the changes of brain bleeds by nearly one-third, along with the chances that a brain bleed would be severe. IVH rates dropped significantly with the use of steroids in smaller preterm infants up to 29 weeks of gestation, and severe IVH rates between 23 and 40 weeks of gestation also fell. When comparing infants whose mothers who received antenatal steroids and those who did not, it was found that infants who did receive the treatment had lower rates of the most severe intraventricular bleeding (grade 4) than those who did not (3.6% vs. 8.9%). The study found that these benefits were applicable for infants ranging from 22 to 29 weeks’ gestation.
Significance of Steroids for Brain Bleed Treatment:
Intraventricular hemorrhage (“brain bleeds”) is an extremely serious birth injury often caused by oxygen deprivation or birth trauma (whether from a prolonged labor or the use of forceps or vacuum extractors), among other factors. After an episode of oxygen deprivation, brain cells begin to die and break down in a condition called hypoxic ischemic encephalopathy (HIE), causing the cells that make up a baby’s fragile blood vessels to rupture. Brain bleeding caused by HIE can be traced back to numerous events, including umbilical cord compression, placental abruption, uterine rupture and preeclampsia, all of which physicians should be trained to identify and properly handle.
The consequences of brain bleeds are quite severe. If properly treated, damage can be mitigated. If left unrecognized or untreated, IVH can lead to hydrocephalus (swelling of the brain’s ventricles) and cerebral cortex damage, which negatively impacts cognitive function, memory and consciousness. Brain bleeds have also been linked to seizures, cerebral palsy and developmental disabilities.
Dr. Lee states that future research would potentially focus on preventing complications such as developmental delays in premature births. He adds that most hospitals do administer prenatal steroids to mothers about to give preterm birth. However, he also acknowledges that there should be protocols in place to ensure that steroids are administered to mothers at imminent risk of preterm birth.
Intraventricular Hemorrhages and Medical Malpractice
Our medical practitioners and researchers are at the cutting edge of scientific research, and their efforts help inform birth injury discourse scientifically and legally. Understanding the latest research about the best way to reduce the incidence of birth injuries (and resulting complications and disabilities) is in everyone’s best interest.
It is significant to note that this researcher states that steroid administration protocols may fall to the wayside for the most hectic of deliveries. While this may seem understandable on the surface, it is unacceptable for neonatal physicians – medical professionals entrusted with the health of fragile premature infants – to overlook standards of care that ensure optimal outcomes. We commend this professional for his honesty and hope that this statement will remind medical professionals of their professional duties to administer quality healthcare.
If you believe that your child suffers from developmental delays from hypoxic ischemic encephalopathy (HIE) or intraventricular hemorrhaging (IVH), due to a physician’s failure to administer antenatal steroids before delivery of a premature child, please call us for a free case evaluation at 888-419-2229, or contact us here. Our in-house legal and medical staff can evaluate your records free of charge to determine if you are entitled to compensation for medical negligence.