Impact of antenatal XXXX administration on @entity649 in surfactant-treated @entity1 .

@entity1 @entity649 @entity600 @entity619 @entity134 @entity358 @entity230 @entity291
Neonatal @entity358 is primarily responsible for the perinatal morbidity and mortality associated with @entity600 . Recently exogenous surfactant replacement therapy has been used to prevent or treat @entity649 . As part of a multicenter, preventive trial between February 1986 and December 1988 using @entity291 -lung surfactant extract, we treated 147 @entity1 with single dose @entity291 -lung surfactant extract. We analyzed this experience to evaluate the possibility that antenatal @entity230 may be additive (with @entity291 -lung surfactant extract) in reducing both the incidence and severity of @entity649 . Although a reduction in the incidence of @entity649 was observed among the 33 neonates exposed to antenatal @entity619 when compared with the 114 @entity1 given @entity291 -lung surfactant extract alone, the difference was not significant (37.7% vs. 24.2% p = 0.15). However, comparison of neonatal subsets previously shown to benefit most from @entity134 use revealed an additive effect between @entity291 -lung surfactant extract and @entity619 in reducing both the incidence and severity of @entity649 . Of the 99 singleton pregnancies, only 2 of 16 @entity1 treated with @entity291 -lung surfactant extract and @entity619 developed @entity649 , compared with the 33 of 83 @entity291 -lung surfactant extract cases (p less than 0.05). A similar reduction was observed in @entity1 between 28 and 32 weeks' gestation ( @entity291 -lung surfactant extract, 21 of 79 vs. @entity291 -lung surfactant extract and @entity619 , 0 of 24; p less than 0.05). A reduction in disease severity was observed in male offspring (moderate or severe @entity649 only; 22 of 63 vs. 2 of 22; p less than 0.05). Potential confounding variables (e.g., gestational age at birth, birth weight, exposure to tocolytics before delivery, fetal pH at birth) were similar in all comparisons. We conclude that an additive effect between @entity619 and @entity291 -lung surfactant extract is observed in selected cases. It may therefore be appropriate to maximize antenatal @entity134 use in centers where exogenous surfactant is available.
