Single versus multiple courses of antenatal betamethasone and neonatal outcome: a randomized controlled trial.
Indian Pediatr
;
2008 Aug; 45(8): 661-7
Artigo
em Inglês
| 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.
Texto completo:
DisponíveL
Índice:
IMSEAR (Sudeste Asiático)
Assunto principal:
Efeitos Tardios da Exposição Pré-Natal
/
Síndrome do Desconforto Respiratório
/
Feminino
/
Humanos
/
Recém-Nascido
/
Gravidez
/
Betametasona
/
Esquema de Medicação
/
Resultado da Gravidez
/
Aborto Espontâneo
Tipo de estudo:
Ensaio Clínico Controlado
Idioma:
Inglês
Revista:
Indian Pediatr
Ano de publicação:
2008
Tipo de documento:
Artigo
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