Single versus multiple courses of antenatal betamethasone and neonatal outcome: a randomized controlled trial.
Indian Pediatr
;
2008 Aug; 45(8): 661-7
Article
in English
| IMSEAR
| ID: sea-6809
ABSTRACT
OBJECTIVES:
This study compared the beneficial and adverse neonatal effects of a single versus repeated courses of antenatal betamethasone.SETTING:
Tertiary care hospitalDESIGN:
Open labeled, randomized controlled trial.PARTICIPANTS:
Pregnant women (26-33 weeks) at risk of preterm delivery, who received one course of antenatal betamethasone and remained undelivered for 7 days.Those with uncertain gestation, major malformations and frank chorioamnionitis were excluded.INTERVENTIONS:
Subjects were randomized to receive weekly antenatal betamethasone until 34 weeks or no further betamethasone. OUTCOMEMEASURES:
Primary incidence of severe respiratory distress syndrome (RDS). Secondary incidence of non-severe RDS and other neonatal morbidity; birth weight, length and occipito-frontal circumference (OFC); and, development and growth at 6 mo corrected age.RESULTS:
38 subjects were allocated to each group. Severe RDS was similar in multiple and single course groups (7% vs. 3% respectively, P=0.34), as was incidence of other morbidity. Composite outcome of RDS and or death within 28 days tended to be less in multiple course group (P=0.07). Birth anthropometry was similar in the 2 groups. At 6 mo corrected age (n=44), weight and length were significantly lower in multiple course group (p=0.003 and P=0.007, respectively), whereas OFC was not different (P=0.1). There were no differences vis a vis neurodevelopmental outcomes.CONCLUSIONS:
A single course of antenatal betamethasone was as efficacious as multiple courses, with respect to prevention of neonatal morbidity. Multiple antenatal betamethasone courses have long-term adverse effects on infant weight and length growth, but not on OFC and neurodevelopment.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Prenatal Exposure Delayed Effects
/
Respiratory Distress Syndrome
/
Female
/
Humans
/
Infant, Newborn
/
Pregnancy
/
Betamethasone
/
Drug Administration Schedule
/
Pregnancy Outcome
/
Abortion, Spontaneous
Type of study:
Controlled clinical trial
Language:
English
Journal:
Indian Pediatr
Year:
2008
Type:
Article
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