The first 48 hours: Comparing 12-hour and 24-hour betamethasone dosing when preterm deliveries occur rapidly

Haas, David M.; McCullough, W. L.; McNamara, Michael F.; Olsen, Cara

doi:10.1080/14767050600715873

Cited by 13 publications

(8 citation statements)

References 10 publications

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“…8 Other studies failed to show any difference between the two dosing intervals in terms of RDS. [12][13][14] In this study, which included 423 preterm births, RDS was more prevalent in the group that received betamethasone at a 24-hour interval, but the difference between the two groups was not statistically significant. However, these results were statistically significant for births occurring between 32 þ0/7 and 33 þ6/7 weeks' GA (►Table 5).…”

Section: Discussionmentioning

confidence: 61%

The Effect of Betamethasone Dosing Interval on Perinatal Outcomes: 12 Hours or 24 Hours Apart

et al. 2021

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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

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Section: Discussionmentioning

confidence: 61%

The Effect of Betamethasone Dosing Interval on Perinatal Outcomes: 12 Hours or 24 Hours Apart

et al. 2021

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“…Since preterm delivery is unpreventable in some cases, efforts to reduce complications of prematurity are necessary. According to previous studies, intramuscular use of betamethasone, has had bene cial effects in reducing respiratory distress syndrome, NEC, IVH, NICU admission and duration of NICU admission, and neonatal death (5)(6)(7)(8)(9)(10). According to pharmacokinetic studies, intravenous betamethasone reaches the serum therapeutic level faster than intramuscular form and, as a result, reaches the target organs sooner (11)(12).…”

Section: Resultsmentioning

confidence: 99%

Efficacy comparison of intravascular versus intra muscular betamethasone phosphate on neonatal outcomes in the cases of imminent preterm birth.

Kashanian

Eshraghi

Kalani

et al. 2022

Preprint

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Preterm birth is the most important cause of neonatal mortality and morbidity. Finding the best treatment regimen of antenatal corticosteroids, in order to reduce neonatal complications, has been under serious concern.Objective:The purpose of the present study was to compare the efficacy of intravascular (IV) versus intra muscular (IM) betamethasone phosphate on neonatal outcomes in the cases of imminent preterm birth.Method:The study was conducted as a double-blind randomized clinical trial. 136 pregnant women with gestational age of 26- 34 weeks of pregnancy and imminent preterm birth (delivery within 24 hours) were randomly assigned into two groups. Group A received intramuscular betamethasone phosphate as a dose of 12 mg, and group B received a similar dose of betamethasone phosphate intravenously. Women were followed up to delivery, and their neonatal outcomes were compared.Results:The women of the two groups (68 women in each group), did not show a significant difference in maternal age, BMI, gravidity and parity, gestational age at the time of admission and delivery, history of miscarriage and assisted reproductive techniques, delivery route, sex and weight of newborns, and Apgar score in minutes 1 and 5. The need for NICU admission, duration of hospitalization, neonatal respiratory distress syndrome, surfactant requirement, and intubation were lower in the IV betamethasone group. There were no significant differences between the two groups according to necrotizing enterocolitis, intraventricular hemorrhage (IVH) and neonatal death.Conclusion:Using IV betamethasone, in cases where there is no enough time to complete the 24-hour betamethasone course due to the possibility of impending delivery, may reduce neonatal complications due to more rapid action.

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“…There were no pharmacokinetic studies investigating the optimal dose and interval to achieve the desired beneficial effects whilst minimizing any short‐ or long‐term off‐target effects . A small retrospective cohort study compared a 12‐hourly dosing regimen of betamethasone with a 24‐hourly regimen in 166 women who delivered less than 48 hours from commencement of antenatal corticosteroid therapy and demonstrated no significant differences in the rates of respiratory distress syndrome, necrotizing enterocolitis, intraventricular haemorrhage, requirement for respiratory support, length of neonatal intensive care unit stay or neonatal death . A randomized controlled trial which included 228 women and 260 fetuses reported that whilst the 12‐hour dosing of betamethasone compared with the 24‐hour dosing had no impact on the incidence of respiratory distress syndrome (36.5% vs 37.3%, P = .91), there was a statistically significant higher incidence of necrotizing enterocolitis in the group who received 12‐hourly administration (6.2% vs 0.0%, P = .03) .…”

Section: Controversies In the Preterm Periodmentioning

confidence: 99%

Controversies in antenatal corticosteroid treatment

Thevathasan

Said

2020

Prenatal Diagnosis

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Antenatal corticosteroids are now established as one of the cornerstones of therapy in the prevention of neonatal morbidity and mortality prior to preterm birth. Although this practice is widely accepted, a significant number of controversies exist. This review explores the knowledge gaps regarding the use of antenatal corticosteroids in the preterm, late preterm and term populations. Furthermore, the role of antenatal corticosteroids in special populations, such as diabetes, multiple pregnancies and periviable gestations, where high‐quality data from randomized controlled trials are lacking, is also considered.

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The first 48 hours: Comparing 12-hour and 24-hour betamethasone dosing when preterm deliveries occur rapidly

Abstract: Dosing betamethasone in 12-hour intervals may result in similar neonatal outcomes compared to the standard 24-hour regimen when delivery occurs within 48 hours of therapy initiation.

Cited by 13 publications

References 10 publications

The Effect of Betamethasone Dosing Interval on Perinatal Outcomes: 12 Hours or 24 Hours Apart

The Effect of Betamethasone Dosing Interval on Perinatal Outcomes: 12 Hours or 24 Hours Apart

Efficacy comparison of intravascular versus intra muscular betamethasone phosphate on neonatal outcomes in the cases of imminent preterm birth.

Controversies in antenatal corticosteroid treatment

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