27.02.3 Neonatal respiratory distress syndrome

One consequence of premature birth is impairment of lung development in the neonate. This manifests itself as neonatal respiratory distress syndrome and is characterised by a deficiency in lung surfactant which causes the integrity of the lung structure to collapse resulting in severe breathing difficulties. Intraventricular haemorrhage and death may follow. Corticosteroids such as dexamethasone and bexamethasone are used in conjunction with tocolytics as therapies to treat this syndrome. The tocolytics prevent premature birth giving the lungs extra time to develop whilst the steroids act via cell surface receptors to directly activate survival genes. Adverse reactions to these steroids include fluid and electrolyte imbalances, muscle weakness, GI disturbances and hypertension.