***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A double-blind study was design ed to investigate the effects of  antenatal glucocorticoids on the incidence of respiratory distress syndrome ( RDS ) in 128 premature human infants . There was a significant reduction ( P<0.05 ) in the incidence of RDS in the betamethasone-treated infants to 8.7 % compared to an incidence of 22.6 % in the saline-treated controls and 25.0 % in infants whose mothers received methylprednisolone . The effectiveness of betamethasone in reducing RDS was limited to premature infants delivered to mothers with intact fetal membranes and with an initial L/S ratio less than 2.0 . The time between administration of the glucocorticoid and delivery did not significantly affect the incidence of RDS in this study . The failure of methylprednisolone to reduce the development of RDS in premature infants suggests its potential use in maternal therapy during pregnancy with minimal effects on fetal maturation Antenatal steroid therapy reduces the incidence of respiratory distress syndrome ( RDS ) in premature infants . However , animal studies showed a decrease in lung cell number and lower lung weights in fetal rabbits exposed to hydrocortisone . This prompted us to measure flows and lung volumes ( by spirometry and helium-dilution method ) in children greater than 6 years who were part of a study by the Collaborative Group on Antenatal Steroid Therapy .  The effect of antenatal steroids on subsequent pulmonary function had not previously been studied . Of the 158 children originally enrolled before birth , a total of 8 dexamethasone (DEX)- and 11 placebo-treated children were still local residents and fulfilled the criteria of the study ( gestational age , 28 - 34 weeks ; DEX/placebo treatment 1 - 7 days before delivery ) .  Mean heights and weights were normal with no significant differences between the groups . Pulmonary function tests showed no differences in lung volumes or expiratory flows between the children whose mothers had received antenatal DEX and those who had received placebo . These results indicate no adverse effect of antenatal DEX on subsequent lung volumes and expiratory flows in childhood Potential side effects of antenatal administration of corticosteroids to prevent neonatal respiratory distress syndrome were studied in 10- to 12-year-old children whose mothers had participated in a r and omized , double-blind , placebo-controlled trial of betamethasone .  The children had a general physical examination ; parents were interviewed about the medical history of their child with special attention to infectious diseases ; growth data were collected ; and a developmental neurological examination , an ophthalmological examination , and a lung function test were conducted . In the corticosteroid group significantly more hospital admissions because of infectious diseases during the first years of life were reported . On the other variables no differences between the corticoid and the placebo groups were found A prospect i ve double-blind r and omized clinical trial was carried out to determine whether glucocorticoid treatment reduces the risk of respiratory distress syndrome ( RDS ) in prematurely born infants . There were 127 infants born to 122 mothers who received either steroid ( dexamethasone phosphate ) or placebo .  No differences between groups occurred in risk factors for RDS ( eg , prepartum asphyxia , male sex , cesarean section ) . When those who received a full course of dexamethasone therapy were compared with those who received placebo , a significant reduction was found in risk , severity , and deaths due to RDS . An increased incidence of infection in mothers treated with steroid was evident , particularly after premature rupture of membranes . We conclude that steroids are effective in reducing risk of RDS , but safer and more efficacious approaches for the prevention of RDS should be sought In a large multicentered , collaborative r and omized and blinded trial utilizing antenatal corticosteroids , the goals included determining the effectiveness of these agents in accelerating lung maturation , as well as monitoring any short-term or long-term adverse effects of this treatment on the parturient , fetus , and /or infant . More than 100 specific items , pertaining to diagnoses , complications , and outcomes were recorded for the 696 mothers enrolled in the study and their 745 infants . A significantly decreased incidence of necrotizing enterocolitis ( P = .002 ) was found in the infants treated with steroids . The possibility of accelerated intestinal maturation induced by antenatal maternal steroid therapy exists . This treatment regimen is particularly attractive as adverse aspects of steroid therapy at the dosage utilized have not been demonstrated In a prospect i ve , r and omized , double‐blind , multicentre trial the effect of antenatal treatment with betamethasone phosphate was compared with placebo in the prevention of the respiratory distress syndrome ( RDS )  in preterm infants . The dose of betamethasone was 4 mg every 8 h for six doses , unless delivery occurred . The 251 women who were enrolled gave birth to 262 liveborn infants , 130 in the betamethasone and 132 in the placebo group ; the two groups were evenly matched in most respects . The diagnosis of RDS in the newborn was confirmed by two independent assessors . Seven of the 130 infants in the betamethasone group and 16 of the 132 in the placebo  group developed RDS . In infants whose mothers had received at least three injections , RDS was also less frequent in the steroid group than in the placebo group ( 3/104 and 10/104 respectively ; P<0·05 ) . There was a significant reduction of RDS in those born between 24 h and 6 days after entry into the trial ( 0/30 and 8/45 respectively ; P<0·05 ) . The largest difference in frequency of RDS occurred in the subgroup of infants born before 34 weeks gestation , within 8 days of trial entry , and whose mothers had received at least three injections ( 0/27 steroid group and 7/32 placebo group ; P=0·03 ) , and there were also significantly fewer neonatal deaths ( 2/27 and 13/32 , respectively ; P<0·01 ) in this  subgroup . Betamethasone did not provoke earlier delivery . Premature rupture of the membranes and maternal hypertension did not seem to contraindicate the use of steroids : there was no increase in maternal or neonatal sepsis nor in stillbirth in hypertensive pregnancies in the steroid group . Neonatal jaundice was significantly less frequent in the steroid ( 55/129 ) than in the placebo group ( 81/127 ; P<0·01 ) but not in the subgroups born before 34 completed weeks gestation A double-blind controlled study on the prenatal use of betamethasone in the prevention of  respiratory distress syndrome ( RDS )  was carried out on 137 patients from 24 to 34 weeks ' gestation . The incidence of RDS was less in the treated group ( 5 % ) than in control group ( 17 % ) . The neonatal mortality rate was lower in the treated group ( 5 % ) than in the control group ( 18 % ) due to an excess of neonatal deaths in the placebo group This study compares fetal corticoid response from conventional dose ( 12.0 mg ) intramuscular betamethasone to large dose ( 1,000 mg ) intravenous cortisol administered to women in premature labor for  acceleration of fetal lung maturity .  To compare these two regimens , 14 women selected at r and om were treated in groups of seven with either cortisol or betamethasone .  Peripheral levels of unconjugated estriol were measured by specific radioimmunoassay prior to the cortisol dose and at 1 , 4 , 8 , and 12 hours following the dose . The rate of corticoid delivery to the fetal hypothalamic-adrenal axis was estimated by the per cent suppression of unconjugated estriol at each post-treatment interval . Least-squares regression lines fitted ( P less than 0.01 ) for each regimen were compared for time saved ( delta t ) when cortisol was used . Mean delta t ( 1 , 4 , 8 , and 12 hours ) was 9.0 + /- 0.2 S.E.M. hours . It is concluded that : ( 1 ) Intravenous cortisol delivers a fetal corticoid effect that is significantly more rapid in onset and more profound in magnitude than does intramuscular betamethasone and that ( 2 ) the cortisol regimen is probably better suited to the acceleration of fetal lung maturation in premature labor when time is short and rapid action is essential In this study , 500 mg . of hydrocortisone were injected intravenously into 126 women every 12 hours for four doses in a double-blind , r and omized fashion . These 126 subjects were at risk for delivery of a premature infant because of premature labor of fetomaternal disease necessitating intervention . There were 67 patients in the treatment group and 59 in the placebo group . All patients had immature lecithin/sphingomyelin ratios and /or were at less than 34 weeks ' gestation . From these data , it appeared that there was a significant decrease in respiratory distress syndrome when the treatment group was compared to the placebo group . The neonatal survival rates also were improved significantly by steroid treatment . There was no demonstrable adverse steroid effect in mothers of fetuses in the long-term or short-term follow-up period , although a significant number of patients were lost to follow-up and the methodology of infant evaluation was imprecise . It would appear from these data that the injection of steroids is beneficial in mothers at risk of being delivered of premature infants . However , many questions remain to be answered before this method can be relied upon as therapy for women with premature labor OBJECTIVES A placebo-controlled , r and omized , double-blind study was performed to determine whether prenatal dexamethasone ( DEX ) treatment improves the outcome of the preterm infant when exogenous surfactant is available . METHODS 157 pregnant women at five hospitals with threatened preterm delivery and with lengths of gestation < 32 weeks received either DEX ( dose 6 mg four times at 12-hour intervals ) or placebo ( PL ) . Prenatal treatment was not repeated . Preterm infants received rescue therapy of human surfactant ( maximum four doses ) if they required ventilatory support and at least 40 % oxygen for the treatment of respiratory distress syndrome ( RDS ) . RESULTS Enrolled pregnant women delivered 188 live-born neonates , of whom 79 ( DEX 41 and PL 38 neonates ) were born 1 to 14 days after the prenatal treatment . Neonates born within 1 to 14 days after the initial DEX treatment had a lower incidence of RDS ( DEX , 44 % ; PL , 79 % ; P < .01 ) , lower requirements of surfactant ( DEX , 22 % ; PL , 53 % ; P < .01 ) , shorter duration of ventilatory support ( DEX , 2.0 days ; PL , 5.3 days ; P < .05 ) and oxygen therapy  ( DEX , 2.0 days ; PL , 7.0 days ; P < .01 ) , and a higher neonatal survival without ventilatory support ( P < .05 ) than PL-treated neonates . DEX-treated neonates had higher mean blood pressure than PL-treated neonates during the first 3 days after birth . Among all neonates treated with DEX , there was a lower incidence of intraventricular hemorrhage or periventricular leucomalacia ( DEX , 13 % ; PL , 33 % ; P < .01 ) . Reduction in the incidence of intraventricular hemorrhage or periventricular leucomalacia in DEX-treated neonates was particularly associated with exogenous human surfactant therapy ( DEX+surfactant 10 % ; PL+surfactant 48 % ; P < .01 ) . CONCLUSIONS Prenatal DEX treatment combined with exogenous human surfactant therapy  in preterm infants decreases pulmonary morbidity and cerebral complications , and increases survival without severe morbidity One hundred forty-six pregnant women were enrolled in a prospect i ve double-blind study to assess the effectiveness and side-effects of antenatal administration of betamethasone in the prevention of respiratory distress syndrome ( RDS ) in potentially premature infants . On admission to the study , the women were given , at r and om , either 12 mg of betamethasone or placebo . The same dose was repeated 24 hours later and then weekly up to 34 weeks of gestation . Gestational age of the infants ranged from 25 to 34 weeks , and birth weights ranged between 730 and 2,650 gm . Statistically significant differences in favor of the infants in the betamethasone group were found in the incidence of RDS , 20.7 % in the betamethasone group compared with 59.5 % in the control group ( P less than .005 ) ; in the severity of RDS ( P less than .05 ) ; and in the death rate ( P less than .05 ) . A higher incidence of hypoglycemia was found among infants in the betamethasone group ( P less than .05 ) . Prolonged rupture of the membranes played no protective role against RDS , and the incidence of infection was similar in both groups A prospect i ve , r and omized study was conducted comparing the use of betamethasone and early delivery , early delivery alone , and expectant management in patients in the 28th to 34th week of pre 
    Output:
    
These benefits extended to a broad range of gestational ages and were not limited by gender or race .
No adverse consequences of prophylactic corticosteroids for preterm birth have been identified .
REVIEW ER 'S CONCLUSIONS Corticosteroids given prior to preterm birth ( as a result of either preterm labour or elective preterm delivery ) are effective in preventing respiratory distress syndrome and neonatal mortality .