Impact of Prophylactic Betamethasone Indication on the Neonatal Outcome in 38-Week Pregnancies Prior to Elective Cesarean Section

Abstract

Objective: To assess whether the use of prenatal betamethasone in pregnancies with elective Caesarean section (C-section) at 38 weeks has a similar risk of adverse neonatal respiratory outcomes than elective C-section at 39 weeks. Methods: Retrospective cohort study of pregnant patients with singleton pregnancies and elective C-section at term in a one-year period. Cases were C-section at 38 weeks of gestation with a complete course of betamethasone started 48-hours before. As a control group, pregnancies with a C-section at 39 weeks without betamethasone were included. Results: During the study period, 186 patients were included. Of these, 91 were delivered at 38 weeks and 95 at 39 weeks. There were no significant differences in maternal age and parity. Moreover, there were no significant differences in respiratory complications (respiratory distress syndrome [RDS] = 0% vs 1.1%; p = 1.0, transitory tachypnea [TT] = 0% vs 0%) and admission to Neonatal Intensive Care Unit (NICU) (8.8% vs 6.3%; p = 0.7) between deliveries at 38 weeks and 39 weeks, respectively. Conclusion: Prophylactic use of betamethasone in early term pregnancies who undergo an elective C-section at 38 weeks is associated with similar adverse neonatal respiratory outcomes than patients with C-section at 39 weeks without corticosteroids.

Risks Versus Benefits of Using Aspirin, Magnesium Sulfate, Corticosteroids, and Progesterone during Pregnancy

“…In this way, the authors of this chapter carried out a randomized case-control study in which some patients received a course of corticosteroids at 37 + 5 and 37 + 6 and were operated on at 38 weeks, and the controls at 39 weeks who did not receive this indication. The results of this study are encouraging, because they show that in selected cases and exceptionally, the administration of corticosteroids at 38 weeks prior to an elective cesarean section does not have worse results than an elective cesarean section at 39 weeks (RDS 0% vs. 1.1%, p = 1.0, transient tachypnea 0% vs. 0% and admission to neonatal intensive care unit 8.8% vs. 6.3%, p = 0.7) [54].…”