Abstract
BackgroundThe association between maternal serum concentration of betamethasone given for fetal lung maturity and perinatal outcome has not been investigated. This may be due to an absence of a reliable method for measuring serum betamethasone concentrations. We aimed in the current study to assess the feasibility of a specific ELISA kit to measure the concentrations of betamethasone in maternal serum and to examine the trend of sequential measurements after a course of betamethasone for fetal lung maturity.MethodsPregnant women at risk for preterm birth who received betamethasone between 24 and 34 weeks of gestation were prospectively included. Serum concentrations were determined before administering betamethasone (baseline), and 36 hours, 48 hours, 72 hours, and 5 to 7 days after the 1st dose. Betamethasone concentration in samples was determined using Corticosteroid ELISA kit. The Friedman test was used to test whether there were significant differences between the measurements.ResultsFive singleton pregnancies were included. Using the ELISA kit, betamethasone concentration in maternal serum samples was obtained for all women. Among the five measurements performed, the concentration was highest at 36 hours after the 1st dose and close to baseline at the 5th measurement performed after 5 to 7 days (p < 0.05). Serum concentration varied at each time point between the five women but similar trend was observed.ConclusionBetamethasone concentration is measurable in the serum of pregnant women with this ELISA kit.
Highlights
The association between maternal serum concentration of betamethasone given for fetal lung maturity and perinatal outcome has not been investigated
The currently accepted dosage of betamethasone was determined by Liggins and Howie in the 1970s; since that time, pregnant women at risk for preterm birth have been administered a fixed dosage of betamethasone, regardless of gestational age, maternal body mass index, and the presence of a singleton or multiple gestation [8]
In order to examine whether betamethasone levels are measurable and in order to examine the dynamics of betamethasone concentrations against time from treatment, blood samples were drawn from each participating woman at five time points: immediately before administering the betamethasone; at 36 hours after the first dose; at 48 hours after the first dose; at 72 hours after the first dose, and 5 to 7 days after the first dose, given that a preterm birth did not occur earlier
Summary
The association between maternal serum concentration of betamethasone given for fetal lung maturity and perinatal outcome has not been investigated. This may be due to an absence of a reliable method for measuring serum betamethasone concentrations. Preterm birth is a major contributor to perinatal mortality and morbidity and affects approximately 7 to 12% of births in developed countries [1]. It is responsible for approximately 75% of all neonatal deaths and 50% of childhood neurological morbidities. For that reason the optimal dosage for betamethasone in terms of benefit and safety is still unknown
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