Abstract
BackgroundPrenatal corticosteroid administration in preterm labor is one of the most important treatments available to improve neonatal outcomes; however, its beneficial effects on late preterm infants (after the 34th week of gestation) remained unknown. We aimed to assess the effects of betamethasone on the clinical condition of the late preterm infants born between 34 and 36 weeks of gestation.MethodsThis retrospective cohort study was performed on 100 consecutive infants born between 34 and 36 weeks of gestation and received betamethasone before delivery as the cases and 100 neonates with the same delivery conditions but without receiving betamethasone. All neonates were followed up within hospitalization to assess the neonatal outcome.ResultsThe neonates receiving betamethasone suffered more from respiratory distress syndrome (49% versus 31%, p = 0.008, RR = 1.59 95% CI (1.12–2.27)) and requiring more respiratory support (71% versus 50%, p = 0.002, RR = 1.43 95% CI (1.13–1.80)) as compared to the control group. There was no difference between the two groups in other neonatal adverse events or death.Conclusionthe use of betamethasone in the late preterm period (after 34 weeks of gestation) has no beneficial effects on lung maturity or preventing neonatal adverse outcomes, even may lead to increase the risk for RDS and requiring respiratory support.
Highlights
Improvements in maternal and neonatal health have been achieved over the past 30 years, which cannot guarantee a reduction in the incidence of preterm labor, but can cause significant changes in morbidity and fetal and neonatal survival
With regard to neonatal consequences and outcomes (Table 2), it was found no difference between the two groups of neonates in the prevalence rate of some neonatal complications including tachypnea of the newborn (TTN), neonatal apnea, necrotizing enterocolitis (NEC), sepsis, intraventricular hemorrhage (IVH), hypoglycemia, requiring neonatal resuscitation, Positive pressure ventilation (PPV) or continuous positive airway pressure (CPAP), tracheal intubation, needing surfactant use, asphyxia, or Apgar score
In another clinical trial by Gyamfi-Bannerman et al [18] that examined the effect of corticosteroids on late preterm deliveries, secondary outcomes such as respiratory problems and the need for surfactant were significantly lower in the betamethasone group but the incidence of hypoglycemia was higher in the betamethasone group and there was no significant difference in the need for CPAP and Neonatal Intensive Care Unit (NICU) hospitalization between the two groups
Summary
Improvements in maternal and neonatal health have been achieved over the past 30 years, which cannot guarantee a reduction in the incidence of preterm labor, but can cause significant changes in morbidity and fetal and neonatal survival. Premature labor is a partial common phenomenon that has been identified in 7 to 10% of all pregnant women [1] In this condition and to maximized fetal lung development, some conservative treatments. Corticosteroids in women at high risk for preterm delivery further improve the neurodevelopmental condition of those born before 34 weeks of gestation [14]. Prenatal corticosteroid administration in preterm labor is one of the most important treatments avail‐ able to improve neonatal outcomes; its beneficial effects on late preterm infants (after the 34th week of gestation) remained unknown. We aimed to assess the effects of betamethasone on the clinical condition of the late preterm infants born between 34 and 36 weeks of gestation
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