Objective Antenatal steroids are commonly used to stimulate fetal lung maturation, particularly in pregnancies at risk of early preterm labor. This study aimed to compare the effects of administering betamethasone at a 12- versus 24-hour interval on perinatal outcomes.
Study Design This retrospective study included 423 early preterm births from 26+0/7 to 33+6/7 weeks of gestation. Patients received betamethasone at either a 12- or 24-hour dosing interval.
Results When all patients in each group were evaluated together, there was no statistically significant difference between both groups for complications of prematurity, including respiratory distress syndrome (RDS). When the two groups were divided by gestational age (GA), the 32+0/7 to 33+6/7-week group that received betamethasone at a 24-hour interval had statistically lower 1- and 5-minute APGAR scores (p = 0.06 and p = 0.02, respectively). They also had a greater need for neonatal intensive care unit (NICU), NICU length of stay, RDS, and need for surfactant (p = 0.20, p = 0.09, p = 0.27, and p = 0.23, respectively) than did the infants at 32+0/7 to 33+6/7 weeks, who received betamethasone at a 12-hour interval. In the group with GA between 28+0/7 and 29+6/7 weeks, the 1-minute APGAR score was lower (p = 0.22), and the durations of hospital stay, and mechanical ventilation were longer (p = 0.048, p = 0.21, respectively) in the 24-hour interval group. No statistically significant difference was observed for all parameters in other GA groups.
Conclusion A 12-hour dosing interval for betamethasone appears to be more appropriate, as it results in a reduction in some neonatal complications and provides a short dose interval.
Key Points
Objective: To evaluate the effects of antenatal steroid administration on neonatal outcomes in late preterm births.Methods: Demographic and neonatal data from women who gave birth between May 2018 and March 2021 at 34 +0 -36 +6 weeks of gestation were screened from the information system of the hospital. The patients were assigned to two groups: those who were and those who were not given steroids. All parameters were compared between the two groups.
Results:The 1-minute (9 versus 8) and 5-minute (10 versus 9) Apgar scores, need for a neonatal intensive care unit (NICU) stay (23.7% versus 27.8%), length of stay (Day) in the NICU (1.97 ± 0.24 versus 2.45 ± 0.16), rate of transient tachypnea of the newborn (3.3% versus 7.8%), respiratory distress syndrome (2.5% versus 5.2%), need for mechanical ventilation (1.2% versus 3.8%), and neonatal sepsis (1% versus 2.6%) were lower in the group that received betamethasone compared with the group that did not; the differences between the two groups were statistically significant.
Conclusion:Based on the results of the present study, we believe that antenatal steroid administration would be beneficial before late preterm births occurring between 34 +0 and 36 +6 weeks of pregnancy, considering the significant reduction in various respiratory complications, especially in respiratory distress syndrome and the need for an NICU stay. K E Y W O R D S betamethasone, late preterm, respiratory distress syndrome, transient tachypnea of the newborn How to cite this article: Bulut AN, Cundubey CR, Ceyhan V, Aydin E. Comparison of neonatal outcomes with and without the administration of betamethasone in late preterm births. Int
ObjectivesThe purpose of this study is to follow the birth process with transperineal ultrasonography (TPU) and predict the delivery method using angle of progression (AOP).MethodsThe study included 134 patients. The AOP was examined with TPU in the lithotomy position applied at 4-h intervals, not at a time of straining or contractions. The relationship was examined between AOP and those who continued with vaginal delivery, and those who underwent caesarean section delivery.ResultsA total of 122 (91%) patients had vaginal delivery and 12 (9%) patients had cesarean delivery. In patients giving vaginal delivery, progress in AOP was observed in every 4-h measurement, but not in patients with cesarean section. In the ROC analysis, if 70% sensitivity and 75% specificity with AOP degree >132.5°, the patient was expected to have vaginal delivery with a probability of 77.5% (95% CI 0.62–0.93; p=0.002).ConclusionsRather than repeating digital examinations, the labour process can be monitored with serial TPU and the type of delivery can be predicted. There is a need for further studies for the measurement of AOP with TPU to become a part of clinical practice in the monitoring of the whole labour process.
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