disease, or even death. Whether newborn screening and early treatment mayprevent the development of a nutritional deficiency is not known.

doi:10.1016/j.earlhumdev.2008.09.248

Abstract UENPS.233Prenatal corticosteroids and respiratory distress: Is there benefit inpreterm babies with 34 weeks of gestation?

Sónia Antunes⁎, Dora Fontes, Susana Gomes, Ana SerranoHospital Espirito Santo de Évora, E.P.E, Évora, Portugal

Background and aim

Previous studies have shown that prenatal corticosteroids (PC) signifi-cantly reduce the incidence of respiratory distress syndrome (RDS) inpreterm babies born before 34 weeks of gestation. Their use at 34 weeks andafter is not a common practice in all centres and there is controversy abouttheir effective benefit. A recent study suggests that PC are effective inreducing RDS and transient tachypnoea of the newborn (TTN) in term babiesdelivered by elective caesarean section.

The aim of this study is to assess if the use of PC in newborns with 34weeksof gestation reduced the incidence and severity of respiratory distress (RD).

Materials and methods

Retrospective case–control study.Review of the clinical registers of all newborns with gestational age

between 34weeks and 0 days and 34weeks and 6 days, born between January2003 and December 2007. The newborns includedwere divided into 2 groups:in Group I (cases) were included the newborns of mothers to whom wereadministrated PC and in Group II (controls) were included those that had noPC. The newborns admitted toNeonatal Intensive CareUnitwere considered ashaving RD in the first 24 h of life, with tachypnoea, chest retractions or nasalflaring and that needed oxygen therapy. We admitted as criteria of gravity ofRD the need for ventilation, duration of oxygen therapy and length of hospitalstay. The statistical analysis was performed with the Statistical PackageSocial Sciences (SPSS), version 16.0. The tests usedwere Fisher's Exact Test andt-student. It was considered a p value<0.05 as statistically significant.

Results

Seventy seven children were included in the study, 31 in Group I and 46in Group II. There was no statistically significant difference in birth weightand sex between the two groups. The number of caesareans was significantlyhigher in group I (71% vs. 48%, p=0.037), but when considering the mode ofdelivery there was no significant difference in the incidence of RD. There wasneed for resuscitation only in Group II (17%, p=0.012). There was nodifference concerning the incidence of RD, RDS or TTN, need for ventilation,duration of oxygen therapy or days of hospital stay.

Conclusions

In our study the use of PC didn't prove to reduce the incidence or severityof RD in newborns with 34 weeks of gestation.

doi:10.1016/j.earlhumdev.2008.09.249

Abstract UENPS.234Vascular ring: A rare cause of persistent respiratory symptoms in a verylow birth weight infant

Akin Ilke Mungan, Begum Atasay, Emel Okulu, Saadet Arsan⁎, Tomris TurmenAnkara University, Ankara, Turkey

Background and aim

Bronchopulmonary dysplasia (BPD) and persisting respiratory symptomsflared with gastroesophageal reflux (GER) and viral infections became fairly

common respiratory complaints of the small graduates in the follow-upperiod. We present a former very low birth weight infant whose respiratorysymptoms persisted for months with partial relief in response to sympto-matic therapies against BPD and GER.

Materials and methods

The baby was born at 31 weeks of gestation and stayed in NICU for38 days. On the 2nd month of life she was brought to our outpatient clinicwith the complaints of cough, wheezing and cyanosis and given symptomatictherapy with the diagnosis of viral pneumonia. After discharge, symptomspersisted with the predominance of wheezing, coughing, head tilting andvomiting after feeding. Unilateral hyperlucency and hyperinflation on thechest radiograms were prominent. Bronchoscopy revealed external compres-sion of left main bronchus with a pulsatile structure. Right aortic arch andaberrant left subclavian artery were found on thorax CT angiography.

Results

On the postnatal 9th month she was operated and a right aortic arch, leftsubclavian artery and a left ligamentum arteriosum passing along the superiorsurface of the left main-stem bronchus, causing compression of an underlyingmalacic trachea segment were detected. After surgery, though respiratorysymptoms improved, difficulty in feeding and swallowing solid foods remained.

Conclusions

Inspiratory stridor, dyspnea, cough, wheezing, recurrent respiratory tractinfections and dysphagia are common symptoms during early childhood, but theirpersistence should alert the general pediatrician for the differential diagnosis ofdisease states, one of which is vascular ring. The diagnosis of vascular ring is oftenoverlooked due to the relatively rare incidence, the nonspecific nature and highprevalence of these symptoms in the pediatric population especially in formerprematures. It is important for the general pediatrician to be familiar with thecondition and the appropriate diagnostic workup.

doi:10.1016/j.earlhumdev.2008.09.250

Abstract UENPS.235Bile acids cause lung injury through phospholipase A2 activityenhancement, revertible by exogenous surfactant administrationAn in vitro study in an extracellular model of aspiration

Daniele De Luca⁎a, Angelo Minuccib, Enrico Zeccac, Marco Piastraa,Pietrini Domenicoa, Giorgio Contia, Ettore Domenico CapoluongodaPediatric Intensive Care Unit, Department of Anaesthesiology and IntensiveCare, Catholic University of the Sacred Heart, University Hospital “A. Gemelli”,Roma, ItalybLaboratory of Clinical Molecular Biology, Institute of Biochemistry and ClinicalBiochemistry, University Hospital “A. Gemelli”, Catholic University of the SacredHeart, Roma, ItalycDivision of Neonatology, Department of Pediatrics, University Hospital “A.Gemelli”, Catholic University of the Sacred Heart, Roma, ItalydLaboratory of Clinical Molecular Biology, Institute of Biochemistry and ClinicalBiochemistry, University Hospital “A. Gemelli”, Roma, Italy

Background and aim

Secretory phospholipase A2 (sPLA2) has a key role in acute respiratorydistress syndrome causing surfactant degradation and increasing inflamma-tion. Bile acids (BA) are supposed to be toxic for the lung and implicated indifferent lung injury forms, such as meconium aspiration, neonatal bile acidpneumonia and aspiration due to gastroesophageal reflux. We sought tostudy the interaction sPLA2-BA in an extracellular environment.

Materials and methods

We collected bronchoalveolar lavage fluid (BALF) from 23 neonates/infants aged <6 months with no lung disease and ventilated because ofgeneral anaesthesia requirement.

Abstracts S97