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Premature Infant: Treating Underdeveloped Lungs

Topic Overview

Particularly when an infant is born before 36 weeks' gestation, the premature infant's lungs are immature, and the body has limited muscle strength and energy for breathing. So the premature infant may not get enough oxygen. This can cause serious medical complications. It is common at birth for a premature infant to need oxygen therapy, a ventilator, and/or medicine to help with oxygen absorption and breathing.

Infants whose lungs have been quickly matured with corticosteroid treatment before birth (antenatal corticosteroids, given by injection to the mother) have a lot fewer medical complications than those who are not treated.

Infants with underdeveloped lungs often lack surfactant, a substance that coats the airways, preventing them from collapsing and sticking together. When premature lungs are treated with surfactant after birth, the infant's blood oxygen levels usually improve within minutes. Surfactant treatment reduces the risk and the severity of respiratory distress syndrome (RDS) in premature infants as well as the overall risk of death.1 Surfactant also helps treat RDS.

Unlike corticosteroid treatment before birth, giving corticosteroids to a baby after birth (postnatal) is losing favor in the medical community. Current research is focusing on how this medicine can be safely used to improve lung function without causing neurological deficits, gastrointestinal bleeding and damage, blood sugar problems, and high blood pressure.

Related Information

References

Citations

  1. Cunningham FG, et al. (2010). Diseases and injuries of the fetus and newborn. In Williams Obstetrics, 23rd ed., pp. 605–643. New York: McGraw-Hill.

Other Works Consulted

  • Engle WA, Committee on Fetus and Newborn (2008). Surfactant-replacement therapy for respiratory distress in the preterm and term neonate. Pediatrics, 121(2): 419–432.
  • Soll R, Özek E (2010). Prophylactic protein free synthetic surfactant for preventing morbidity and mortality in preterm infants. Cochrane Database of Systematic Reviews (1).

Credits

By Healthwise Staff
Sarah Marshall, MD - Family Medicine
Kimberly Dow, MD, FRCPC - Neonatology
Last Revised March 22, 2013

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