Abstract
Background: Single course of BM decreases neonatal morbidity when administrated within 7 days before preterm delivery. The benefits of second course of BM are unknown.
Aims: To evaluate the efficacy of second course of BM in increasing the intact survival of preterm infants.
Methods: In this randomized, blinded trial, pregnant women (before 34.0 gestational weeks) were eligible if they had remained undelivered more than 7 days after antenatal BM. Single dose of BM (12 mg) or placebo was given, when the preterm delivery was anticipated. Primary outcome was intact survival without respiratory distress syndrome and/or intracerebral hemorrhage (grade 3–4).
Results: 251 mothers participated the study. All infants were delivered prior to 35 weeks of gestation. At present the outcome of 285 infants has been analyzed. The intact survival was 48% in BM and 58% in placebo groups (P=0.1). The intact survival was non-significantly higher in BM group (58% vs. 41%, P=0.3), when the study drug was administered more than 24 h before birth (group 1). The incidence of intact survival was lower in BM group (44% vs. 61%, P=0.01), when the intervention took place less than 24 h before birth (group 2). In group 1, the risk of patent ductus arteriosus was 16% in BM and 41% in placebo group (P=0.04), vs. 29% and 27% in group 2. In group 2, systolic and diastolic blood pressures were increased in BM arm (P=0.02 and P=0.03). In group 1, blood pressure levels were similar between study groups. The second course of BM did not influence the acute outcome of preterm infants. The preterm infants benefited from antenatal BM, when treatment was given more than 24 h before delivery. BM given less than 24 hours before delivery was associated with increased blood pressure after birth and with a decrease in intact survival.
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Peltoniemi, O., Kari, M., Halmesmäki, E. et al. 288 The Effect of Second Course of Antenatal Betamethasone (BM) on Neonatal Morbidity in Preterm Infants: A Randomized Trial. Pediatr Res 58, 404 (2005). https://doi.org/10.1203/00006450-200508000-00317
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DOI: https://doi.org/10.1203/00006450-200508000-00317
