Study on effects of steroid on clinical course, short-term and long-term outcomes in neonates with meconium aspiration syndrome

The definite role of steroids in meconium aspiration syndrome (MAS), their safety and short-term as well as long-term outcomes are yet to be evaluated in large clinical trials; although some recent studies have yielded encouraging results. A randomized controlled trial was conducted over three years involving 275 neonates, where one group (n = 137) received intravenous (IV) methylprednisolone and nebulized budesonide along with the conventional management (IV normal saline and nebulized 3% saline), and the other group (n = 138) received conventional management only. These infants were followed up at 1, 3, and 6 months after discharge. We noticed a remarkable and statistically significant improvement in the clinical course including reduction in the Downes' score, oxygen dependency, the need of mechanical ventilation, and respiratory distress as well as a reduction in long-term complications including bronchopulmonary dysplasia, cerebral palsy etc.; in neonates receiving IV and nebulized steroid. We also did not observe any increased rate of sepsis, hypoglycemia, necrotizing enterocolitis in this group.