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Current Clinical Pharmacology

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ISSN (Print): 1574-8847
ISSN (Online): 2212-3938

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Clinical Trial

Prenatal Administration of Betamethasone and Neonatal Respiratory Distress Syndrome in Multifetal Pregnancies: A Randomized Controlled Trial

Author(s): Fatemeh Abbasalizadeh, Khadijeh Pouya, Raana Zakeri, Rana Asgari-Arbat*, Shamsi Abbasalizadeh and Neda Parnianfard

Volume 15, Issue 2, 2020

Page: [164 - 169] Pages: 6

DOI: 10.2174/1574884714666191007154936

Abstract

Background: Neonatal Respiratory Distress Syndrome (NRDS) is one of the most frequent causes of neonatal mortality especially in premature infants. Although it has been well established that maternal antenatal corticosteroid therapy has a positive effect on NRDS reduction, yet the effectiveness of this treatment in multifetal pregnancies is dubious.

Objective: We aimed to investigate the effect of betamethasone therapy on the incidence of NRDS in multifetal pregnancies through a randomized controlled trial.

Methods: 140 women with a multifetal pregnancy at less than 28 weeks’ gestational age were randomly allocated into intervention and control groups. Women at the intervention group received intramuscularly betamethasone (12 mg/kg/BW twice). Neonatal outcomes were evaluated between two groups of intervention and control, and two subgroups of preterm and term births. This study is registered with the Iranian Clinical Trials Registry, number IRCT20180227038879N1.

Results: The incidence of NRDS was significantly lower in infants of betamethasone group than the ones in the control group (4.9% vs 18.1%, P=0.034) while it did not show a significant reduction in preterm infants compared to mature ones. Also, the intervention group presented a significant lower neonatal ventilation than the control group (47.2% vs 63.2%, P=0.041). Other neonatal outcomes, including age at birth, birth weight, Apgar score, NICU admission, and the number of mortalities were not significantly different between study groups.

Conclusion: Betamethasone therapy during 28-32 weeks of gestation in multifetal pregnancies was associated with better neonatal outcomes through significant reductions in NRDS incidence and requiring ventilator treatment. However, betamethasone administration did not reduce the chance of NRDS in premature infants.

Keywords: Neonatal respiratory distress syndrome, multifetal pregnancies, betamethasone, antenatal corticosteroid, clinical trial, gestation.

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[1]
Laws PJ, Sullivan DE, Grayson N. Australia’s mothers and babies. Sydney: AIHW National Perinatal Statistics Unit 2004.
[2]
Kliegman RM, Stanton BM, Geme JS, Schor NF. Nelson Text-book of Pediatrics E-Book. Maryland: Elsevier Health Scienc-es 2015.
[3]
Gerten KA, Coonrod DV, Bay RC, Chambliss LR. Cesarean delivery and respiratory distress syndrome: Does labor make a difference? Am J Obstet Gynecol 2005; 193(3 Pt 2): 1061-4.
[http://dx.doi.org/10.1016/j.ajog.2005.05.038] [PMID: 16157112]
[4]
Qiu X, Lee SK, Tan K, Piedboeuf B, Canning R. Canadian Neonatal Network. Comparison of singleton and multiple-birth outcomes of infants born at or before 32 weeks of gesta-tion. Obstet Gynecol 2008; 111(2 Pt 1): 365-71.
[http://dx.doi.org/10.1097/AOG.0b013e318162688f] [PMID: 18238974]
[5]
Hintz SR, Van Meurs KP, Perritt R, et al. NICHD Neonatal Research Network. Neurodevelopmental outcomes of premature infants with severe respiratory failure enrolled in a randomized controlled trial of inhaled nitric oxide. J Pediatr 2007; 151(1): 16-22.
[6]
Crowther CA, Haslam RR, Hiller JE, Doyle LW, Robinson JS. Australasian Collaborative Trial of Repeat Doses of Steroids (ACTORDS) Study Group. Neonatal respiratory distress syndrome after repeat exposure to antenatal corticosteroids: A randomised controlled trial. Lancet 2006; 367(9526): 1913-9.
[http://dx.doi.org/10.1016/S0140-6736(06)68846-6] [PMID: 16765760]
[7]
Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 1972; 50(4): 515-25.
[PMID: 4561295]
[8]
Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev 1996; 1.
[9]
Turrentine MA, Wilson PD, Wilkins IA. A retrospective analysis of the effect of antenatal steroid administration on the incidence of respiratory distress syndrome in preterm twin pregnancies. Am J Perinatol 1996; 13(6): 351-4.
[http://dx.doi.org/10.1055/s-2007-994355] [PMID: 8865981]
[10]
Quist-Therson EC, Myhr TL, Ohlsson A. Antenatal steroids to prevent respiratory distress syndrome: Multiple gestation as an effect modifier. Acta Obstet Gynecol Scand 1999; 78(5): 388-92.
[http://dx.doi.org/10.1080/j.1600-0412.1999.780508.x] [PMID: 10326882]
[11]
Al-Yatama MK, Al Essa M, Omu AE, Al-Shamali I, Egbase P, Rashwan N. Effect of repeated doses of dexamethasone on the incidence and severity of respiratory distress syndrome in multifetal gestation between 24 and 34 weeks. Gynecol Obstet Invest 2001; 52(1): 26-33.
[http://dx.doi.org/10.1159/000052936] [PMID: 11549860]
[12]
Blickstein I, Shinwell ES, Lusky A, Reichman B, Network IN. Israel Neonatal Network. Plurality-dependent risk of respiratory distress syndrome among very-low-birth-weight infants and antepartum corticosteroid treatment. Am J Obstet Gynecol 2005; 192(2): 360-4.
[http://dx.doi.org/10.1016/j.ajog.2004.10.604] [PMID: 15695972]
[13]
Choi SJ, Song SE, Seo ES, Oh SY, Kim JH, Roh CR. The effect of single or multiple courses of antenatal corticosteroid therapy on neonatal respiratory distress syndrome in singleton versus twin pregnancies. Aust N Z J Obstet Gynaecol 2009; 49(2): 173-9.
[http://dx.doi.org/10.1111/j.1479-828X.2009.00970.x] [PMID: 19432606]
[14]
Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth Cochrane Database Syst Rev 2017; 3CD004454..
[15]
An international classification of retinopathy of prematurity. Pediatrics 1984; 74(1): 127-33.
[PMID: 6547526]
[16]
Gilstrap LC, Christensen R, Clewell WH, et al. NIH consensus development panel on the effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA 1995; 273(5): 413-8.
[http://dx.doi.org/10.1001/jama.1995.03520290065031] [PMID: 7823388]

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