Cardiac Function of Preterm Infants whose Mothers Received Dexamethasone
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2009-12-30
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Vajira Medical Journal
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Abstract Cardiac Function of Preterm Infants whose Mothers Received Dexamethasone Thanakrit Tarunotai MD Department of Pediatrics, BMA Medical College and Vajira Hospital Objective: To evaluate the cardiac function of preterm infants, whose mothers received dexamethasone during antenatal period. Study design: Prospective descriptive study. Subjects: 95 preterm infants gestational age equal to or less than 34 weeks, who were delivered from mothers, who received 4 doses of dexamethasone, at BMA Medical College and Vajira Hospital during December 2006 and November 2007. Methods: Cardiac function was evaluated by echocardiogram in all subjects for the first time at 7 days of age. The cardiac dysfunction infants were re-evaluated by second echocardiography before discharge from the hospital, when the body weight were about 2,000 grams. All the cardiac dysfunction infants from the second echocardiography underwent third echocardiography at the age of 6 months. Factors that might interfere the cardiac function such as maternal gestational diabetes mellitus, gestational age at birth, birth weight, birth asphyxia, fetal intubation, hypothermia, hypoglycemia and sepsis were recorded. Main outcome measures: Poor cardiac function defined as low ejection fraction and low fractional shortening. Results: 51 subjects were females while 44 were males. The subjects were born at the gestational age of 25-34 weeks with the birth weight of 900 - 2,150 grams. 25 infants (26.3%) had poor cardiac function diagnosed by the first echocardiography at 7 days of age. These infants were treated in the hospital until body weight were about 2,000 grams and underwent second echocardiography evaluations before discharge. The second echocardiography revealed 6 infants (6.3%) with poor cardiac functions. Cardiac functions of all these 6 infants turned to normal from the third echocardiography at 6 months of age. Factors associated with poor cardiac functions in these subjects included less gestational age, low birth weight, birth asphyxia and fetal intubation. Conclusion: The incidence of cardiac dysfunctions in preterm infants whose mother received antenatal dexamethasone was 26.3%. The abnormal cardiac function was transient and turned to normal before 6 months. Vajira Med J 2008 ; 52 : 201-208
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Vajira Medical Journal; Vol. 52 No. 3 September - December 2008; 201-208