The rate of preterm births has remained unchanged for the recent years despite of the persistent attempts to diminish it. Preterm births are responsible for about 70% of neonatal morbidity and mortality. One of the main problems of preterm newborns is their lung immaturity. The aim of this study is to assess the effect of Ambroxol, given prenatally on the rate and severity of neonatal respiratory distress syndrome (NRDS) in preterm infants and its potential to replace the corticosteroid prophylaxis in cases where steroids are contraindicated or undesirable.
Materials and methods: The trial consisted of 33 pregnant women between 27 and 32 week of gestation. 17 of them represented our work group and were given Ambroxol syrup 15 mg/ml, per os 30 ml in three intakes, for 7 days. 16 were controls and were not given any kind of NRDS prophylaxis.
Results: severe NRDS was diagnosed in 2.5 times more cases in the control group compared to the work group. All infants in the control group had clinical signs of NRDS, while 23.5% of the infants in the work group were asymptomatic. Bronchopulmonary dysplasia was diagnosed in 25% of the infants in the control group, compared to none diagnosed in the work group. Newborns with no antenatal NRDS prophylaxis had to be kept in intensive care units for an average period of time twice longer than the newborns to mothers who had received Ambroxol.
Conclusions: Antenatal Ambroxol administration diminishes the rate of NRDS, decreases the duration, scope and price of the intensive care, lessens the duration of assisted ventilation and oxygen needs and hence improves the long-term outcome. Ambroxol and steroids have cumulative effect on fetal lung maturation and therefore should both be a part of the preterm delivery therapeutic scheme.