Betamethasone vs. dexamethasone for preventing morbidity in very low birth weight neonates

Abstract

LOW BIRTH WEIGHT NEONATES DEBORAH FELDMAN, JEANINE CARBONE, LAURA BELDEN, ADAM BORGIDA, CHARLES INGARDIA, VICTOR HERSON, Hartford Hospital, Obstetrics and Gynecology, Hartford, Connecticut, Connecticut Children’s Medical Center, Neonatology, Hartford, Connecticut OBJECTIVE: To compare neonatal outcomes in very low birth weight (VLBW) neonates exposed to antenatal betamethasone vs. dexamethasone. STUDY DESIGN: We performed a review of all VLBW (%1500 grams) infants admitted to our neonatal intensive care unit from January 1997 through February 2006. Maternal medical records were reviewed to determine exposure and type of antenatal steroids. Patients were excluded for gestational age !23 weeks, no steroid exposure, weekly steroid courses, congenital fetal abnormalities, or incomplete medical records. Pregnancy and neonatal outcomes were compared between patients who received betamethasone and those who received dexamethasone. RESULTS: There were 614 VLBW infants admitted to our NICU during the study period, of which 334 met study inclusion criteria. Betamethasone was given in 186 cases, and dexamethasone in 148 cases. Primary neonatal outcomes are shown in the table. No differences were noted in the rates of PVL, ROP, or neonatal sepsis. There were no differences in maternal race, gestational age at delivery, or mean birthweight between the two groups. There was a higher rate of pPROM in the betamethasone group (39.7% vs. 24.4%, P = .007), and a higher rate of IUGR in the dexamethasone group (26.9% v. 14.2%, P = .007). Other pregnancy complications were similar in both groups. CONCLUSION: The use of antenatal betamethasone was associated with a significantly lower rate of pulmonary complications due to prematurity when compared with dexamethasone.