Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour

Saldaña-García, Natalia; Espinosa-Fernández, María Gracia; Gómez-Robles, Celia; Postigo-Jiménez, Antonio Javier; Bello, Nicholas; Rius-Díaz, Francisca; Sánchez-Tamayo, Tomás

doi:10.3390/jcm11010020

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…Bu çalışmada her üç grup arasında intraventriküler kanama, sepsis ve mortalite açısından anlamlı fark bulunmamıştır (14). Başka bir çalışmada 12 mg betametazonun, hiç antenatal steroid uygulanmayanlara göre RDS'yi azalttığı bulunmuştur (8). Bu çalışmada ayrıca antenatal steroid uygulanan grupta daha az mekanik ventilasyon ihtiyacı, daha düşük toplam solunum desteği ihtiyacı ve daha düşük oksijen desteği ihtiyacı olduğu bulunmuştur.…”

Section: Discussionunclassified

“…Aynı çalışmada periventriküler lökomalazi, retinopati ve orta ağır bronkopulmoner displazi sıklığının da tek doz steroid uygulananlarda azaldığı bildirilmiştir. Sonuç olarak, doğumdan önce 3. saate kadar steroid uygulamasının RDS'nin şiddetini azalttığı iddia edilmiştir (8). Tek doz antenatal steroidin etkili olduğunu belirten bu çalışmada hasta sayısının az olması kısıtlılık olarak bildirilmiştir.…”

Section: Discussionunclassified

“…Bu durumda risk altındaki bebekler, doğumun hemen öncesinde tek doz betametazon yapıldıktan sonra doğabilir. Hatta, doğumun ertelenmesinin annenin ya da fetüsün yaşamını tehdit ettiği durumlarda steroid uygulanamayabilir (8). Bu çalışmanın amacı, acil preterm doğumlarda tek doz antenatal steroid tedavisi uygulanan ve steroid uygulanamayan gruplarda kısa ve uzun dönem morbidite ve mortalite açısından fark olup olmadığını belirlemektir.…”

Section: Introductionunclassified

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Tek doz antenatal steroid uygulamasının kısa ve uzun dönem prematüre morbiditeleri üzerine etkisi

Şero

2023

Jour Umraniye Pediatr

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Objective: Preterm birth is one of the most common causes of perinatal mortality and morbidity. While the primary goal is to prevent preterm births, in cases of unavoidable preterm labors, antenatal steroid administration should be carried out. Antenatal steroid administration improves fetal lung maturation and reduces respiratory morbidity. The aim of this study is to determine whether there is a difference in short and long-term morbidities and mortality between emergency preterm births with a single dose of antenatal steroid treatment and those without steroid treatment. Material and Methods: Data of infants born before 30 weeks of gestation who were not administered antenatal steroids for emergency reasons and those who received a single dose of antenatal steroids were retrospectively reviewed, based on cases admitted to the neonatal intensive care unit between January 2017 and January 2022. Two groups were compared in terms of short and medium-term morbidities. Patients' respiratory supports, surfactant requirements, and length of hospitalization were examined retrospectively from their files. Results: Out of a total of 149 patients, 64 (43%) received a single dose of antenatal steroids, while 85 (57%) did not receive antenatal steroids. In both groups evaluated in terms of short-term respiratory morbidities and characteristics, the need for non-invasive and invasive mechanical ventilation support was similar, with no statistically significant difference found. In patients who received a single dose of steroids, 75% were diagnosed with RDS, while in those who did not receive steroids, the diagnosis rate was 69%. Conclusion: Although it is recommended that antenatal steroids be administered at least 24 hours before birth, a large multicenter cohort study (recently conducted) stated that having at least three hours between antenatal steroid and birth improved neonatal outcomes. In case of unforeseen emergency preterm labor; even if antenatal steroid doses cannot be completed as recommended; steroids should be administered even if it is a single dose.

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Section: Discussionunclassified

Section: Introductionunclassified

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Tek doz antenatal steroid uygulamasının kısa ve uzun dönem prematüre morbiditeleri üzerine etkisi

Şero

2023

Jour Umraniye Pediatr

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“…Only a few studies in the literature explored the effects of different dose regimens of antenatal CCS prophylaxis, yielding conflicting results. Studies comparing half course of CCS with no CCS therapy ( 18 – 20 ), showed that the exposure to an incomplete course of prophylaxis decreases the rate of severe neonatal outcomes, especially at very early gestational weeks (25–27 weeks) and in non-tertiary hospitals ( 18 ). Other observational studies compared the administration of an incomplete CCS course vs. a complete CCS course ( 21 – 24 ) demonstrating a significant improvement of the neonatal clinical outcome with the half dose exposure.…”

Section: Discussionmentioning

confidence: 99%

Partial vs. complete course of antenatal corticosteroid prophylaxis: An Italian single center retrospective study

Xodo

Trombetta²,

Celante³

et al. 2022

Front. Pediatr.

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IntroductionThis study aimed to compare the outcomes of preterm infants given 12 vs. 24mg of betamethasone prophylaxis to understand whether a partial course of antenatal corticosteroids (CCS) could prevent or mitigate the major preterm birth complications.MethodsThis is a retrospective single-center cohort study including neonates born between 24 and 34 weeks of gestation from 2001 to 2019 at the University Hospital of Udine. The study population was divided into two groups: one group received 12mg, and another received a 24mg dose of betamethasone before the delivery. A separate analysis was performed for single and multiple pregnancies. The two groups were evaluated for various neonatal outcomes.ResultsThe study population included a total of 1,258 pregnancies and 1,543 neonates delivered between 24 and 34 weeks of gestation, of which 1,022 (803 single and 219 multiple pregnancies) were exposed to the complete CCS prophylaxis, whereas 236 (192 single and 44 multiple pregnancies) received the incomplete CCS prophylaxis. In single pregnancies, as for maternal characteristics, the most significant differences observed between the two groups are the following: a higher prevalence of spontaneous vaginal deliveries in the incomplete CCS prophylaxis (36.46 vs. 23.91%) and, by contrast, a higher prevalence of cesarean deliveries in the complete CCS prophylaxis group (75.72 vs. 63.02%). As for neonatal outcomes, the low Apgar score in the first and fifth min was significantly more prevalent in the incomplete CCS prophylaxis group compared with the complete CCS prophylaxis group. The group of incomplete CCS prophylaxis reported a higher occurrence of the following outcomes: IVH grade 3-4 (7.81 vs. 3.74%, p < 0.05), PVL (7.29 vs. 1.99% p < 0.05), ROP (23.96 vs. 18.06% p = 0.062), and RDS (84.38 vs. 78.83% p = 0.085). After adjusting for covariates, the complete CCS prophylaxis group in single pregnancies was significantly protective for IVH grade 3-4, PVL, and low Apgar's scores. Similar results were found in multiple pregnancies except for RDS.DiscussionThis retrospective single-center cohort study found that, compared with preterm infants treated with 24mg betamethasone in utero, those given half course of betamethasone had a significantly higher prevalence of IVH grade 3-4, PVL, RDS, and lower Apgar scores at 1 and 5 min. In conclusion, the evidence from this single-center retrospective study supports the preference for the complete CCS prophylaxis in women at risk of preterm birth because of its beneficial effect on the main adverse outcomes.

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Complete Versus Incomplete Antenatal Corticosteroid Therapy and Number of Doses of Surfactant Used Posnatally: A Single-Center Study

Mansour,

Harb,

Michel

et al. 2024

AJP

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Introduction: Antenatal corticosteroid therapy reduces the risk of developing RDS in premature infants. A single complete course of two doses of betamethasone is recommended between 24 weeks and 34 weeks. There are few data on the neonatal effects of an incomplete course of antenatal corticosteroid therapy. The main objective of our study is to evaluate the effectiveness of a complete versus incomplete course of antenatal corticosteroid therapy on the number of doses of surfactant received postnatally. Methods: This is a single-center retrospective study, including 145 newborns with RDS, divided into 2 groups according to the number of doses of antenatal corticosteroid therapy (1 dose; n = 23 and 2 doses; n = 95). Results: The clinical characteristics of the newborns were similar in the 2 groups. The number of doses of surfactants received postnatally and the severity of RDS are not influenced by the number of doses of antenatal corticosteroid therapy. On the other hand, the number of doses of surfactants received is influenced by the term of birth, the presence of an neonatal sepsis and by resuscitation in the delivery room. The severity of RDS is not influenced either by the interval between the last dose of antenatal corticosteroid therapy and delivery, nor by the cause of prematurity. We did not note any statistically significant difference in clinical improvement (duration of intubation, duration of non-invasive ventilation), the need for postnatal corticosteroid therapy and the risk of occurrence of morbidity and mortality (mortality rate, occurrence of BPD, IVH, severe NEC) between the two groups. Conclusion: just like a complete course, an incomplete course of antenatal corticosteroid therapy can also act on the severity of RDS. Prospective randomized studies should be considered for a formal determination of the neonatal effects of a complete versus incomplete course of antenatal corticosteroid therapy, including the trial BETADOSE.

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Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour

Cited by 3 publications

References 23 publications

Tek doz antenatal steroid uygulamasının kısa ve uzun dönem prematüre morbiditeleri üzerine etkisi

Tek doz antenatal steroid uygulamasının kısa ve uzun dönem prematüre morbiditeleri üzerine etkisi

Partial vs. complete course of antenatal corticosteroid prophylaxis: An Italian single center retrospective study

Complete Versus Incomplete Antenatal Corticosteroid Therapy and Number of Doses of Surfactant Used Posnatally: A Single-Center Study

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