SUPPORT Study Band of the Eunice Kennedy Shriver NICHD Neonatal Study Network: Early CPAP versus Surfactant in Extremely Preterm Infants It has been shown that surfactant treatment at significantly less than 2 hours of life significantly decreases the prices of death, air leak, and death or bronchopulmonary dysplasia in preterm infants.1,2 Overall, prophylactic treatment with surfactant has not been shown to significantly reduce the threat of bronchopulmonary dysplasia alone, whereas research comparing early with later on rescue use of surfactant have shown that there surely is a decreased risk of chronic lung disease with early use.2 Several studies have shown that the usage of surfactant doesn’t have a significant effect on the risk of subsequent neurodevelopmental impairment,3 although a recently available follow-up evaluation of infants involved in a randomized trial demonstrated that early surfactant treatment in comparison with later surfactant treatment was associated with a significantly higher level of increased muscle tone in the infants and a delay in the infants’ ability to roll from the supine to the prone position http://sildenafilca.org .
Even though observational nature of this scholarly study precludes a summary about cause and impact, these findings support a romantic relationship of the malformations to valproic acid particularly instead of to antiepileptic drugs generally or to underlying epilepsy. Valproic acid is used for numerous indications in Europe, which means that its use is unlikely to be very strongly related to a particular type or severity of epilepsy. Nevertheless, we do not have information on the type or intensity of epilepsy and therefore cannot guideline out the chance of confounding by indication. Studies evaluating the risk of general malformations after in utero exposure to an antiepileptic drug in comparison with no such exposure have shown that the risk is significantly higher with contact with valproic acid than with exposure to other antiepileptic drugs.