Abstract
Objective: To assess whether the use of prenatal betamethasone in pregnancies with elective Caesarean section (C-section) at 38 weeks has a similar risk of adverse neonatal respiratory outcomes than elective C-section at 39 weeks. Methods: Retrospective cohort study of pregnant patients with singleton pregnancies and elective C-section at term in a one-year period. Cases were C-section at 38 weeks of gestation with a complete course of betamethasone started 48-hours before. As a control group, pregnancies with a C-section at 39 weeks without betamethasone were included. Results: During the study period, 186 patients were included. Of these, 91 were delivered at 38 weeks and 95 at 39 weeks. There were no significant differences in maternal age and parity. Moreover, there were no significant differences in respiratory complications (respiratory distress syndrome [RDS] = 0% vs 1.1%; p = 1.0, transitory tachypnea [TT] = 0% vs 0%) and admission to Neonatal Intensive Care Unit (NICU) (8.8% vs 6.3%; p = 0.7) between deliveries at 38 weeks and 39 weeks, respectively. Conclusion: Prophylactic use of betamethasone in early term pregnancies who undergo an elective C-section at 38 weeks is associated with similar adverse neonatal respiratory outcomes than patients with C-section at 39 weeks without corticosteroids.
Highlights
The administration of corticosteroids prior to preterm birth has proven to be one of the indications with greatest impact in neonatal outcome
The present study aims to evaluate if the prophylactic use of betamethasone in patients with elective cesarean section at weeks is associated with similar neonatal respiratory outcomes than cesarean section at weeks without betamethasone
91 patients delivered at 38 weeks with previous betamethasone and 95 patients were delivered at 39 weeks
Summary
The administration of corticosteroids prior to preterm birth has proven to be one of the indications with greatest impact in neonatal outcome. Neonatal morbidity has been shown to be higher in newborns whose mothers were delivered by elective cesarean section at different gestational ages [3]-[10]. In this line, the ASTECS study concluded that the prophylactic administration of betamethasone in term pregnancies (38 or more weeks) 48 hours prior to an elective cesarean section reduced TT and RDS requiring admission to the NICU versus the control group (relative risk RR = 0.46, 95% confidence interval = 0.23 - 0.93) [9]
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