Incidence of idiopathic respiratory distress syndrome during the last ten years

In the Port Royal Maternity Hospital, with about 2000 deliveries per year, the incidence of idiopathic respiratory distress syndrome (IRDS) has been studied during the last ten years. Because of the potential hazards of drugs, the attitude of restricting the use of steroids to a few particular cases was adopted. In period I (1968–1969), the incidence of IRDS was 1 per 100 live births. In period II (1972–1973), the incidence dropped to 0.54% of the live births. In period III (1975–1977), the incidence remained at 0.47% of the live births. The difference in frequency between period I and periods II and III is statistically significant (P < 0.01). This diminution appears to be the result of an overall improvement in the pre- and postnatal care of premature infants.The newborns who could have benefited from prenatal glucocorticoid treatment are studied in period III. From 28 to 34 wk of gestational age, 148 infants were born. Seventy-eight (≠50%) did not have any respiratory problems, 54 had mild and transitory distress and 16 (≠10%) had IRDS. In only 7 cases was the time interval between the first signs of premature labor and delivery longer than 24 h. In conclusion, at least 148 neonates would have had prenatal glucocorticoid treatment, in order possibly to avoid 7 cases of IRDS, which would mean hazard for 20 and benefit for 1. A hazardous effect on brain development seems to be the main concern and has to be more fully documented.