Does the Use of Antenatal Corticosteroids Reduce Respiratory Morbidity in Babies Born in Late Preterm Period?

Author:

Shittu Khadijah A.1,Rabiu Kabiru Afolabi2,Ahmed Bolaji3,Akinola Oluwarotimi I.2,Akinlusi Fatimat2

Affiliation:

1. Royal United Hospital NHS FT Bath.

2. Department of Obstetrics & Gynaecology, Lagos State University Teaching Hospital

3. Programme Department, Damien Foundation Belgium (Nigeria Project)

Abstract

Abstract Objective The aim of this study is to determine the effectiveness of antenatal corticosteroid in reducing respiratory morbidity in babies born in the late preterm period. Materials and methods Two hundred and eighty-six pregnant women at risk of having a late preterm delivery were studied. One hundred and forty-three (143) served as the cases and were given 2 doses of 12mg intramuscular dexamethasone 12 hours apart, while 143 served as the controls and were given a similar quantity of placebo. The women were followed up prospectively and data were collected on the pregnant women and their newborns on a standardized form. The neonates were assessed for acute respiratory distress syndrome and transient tachypnea of the newborn based on clinical signs, symptoms, and chest x-ray results (when indicated). The primary outcome was the occurrence of neonatal respiratory morbidity. Results The primary outcome occurred in 5 out of 130 infants (3.8%) in the dexamethasone group and 31 out of 122 (25.4%) in the placebo group (P value = 0.000003). Birth asphyxia, neonatal intensive care admission and need for active resuscitation at birth also occurred significantly less frequently in the dexamethasone group (P value 0.004, 0.009, 0.014 respectively). There were no significant group differences in the incidence of neonatal sepsis, neonatal jaundice, hypoglycemia and feeding difficulties. Conclusion Administration of dexamethasone to women at risk for late preterm delivery significantly reduced the rate of neonatal respiratory complications neonatal intensive care unit and need for active resuscitation at birth. Trial Registration: PACTR (www.pactr.org) Registration Number: PACTR202304579281358. The study was retrospectively registered on April 19, 2023.

Publisher

Research Square Platform LLC

Reference24 articles.

1. March PMNCH, Save the Children WHO. Born Too Soon: The Global action report on preterm Birth. Howson C, Kinney M, Lawn J, editors. Am. J. Perinatol. Geneva: World Health Organization; 2012.

2. Teune MJ, Bakhuizen S, Bannerman CG, Opmeer BC, Van Kaam AH, Van Wassenaer AG et al. A systematic review of severe morbidity in infants born late preterm. Am J Obstet Gynecol [Internet]. Elsevier Inc.; 2011;205:374.e1-374.e9. Available from: http://dx.doi.org/10.1016/j.ajog.2011.07.015.

3. Respiratory Morbidity in Late-Preterm Births: A Prospective Observational Study at a Tertiary Care Hospital;Shaikh N;J Obstet Gynecol India Springer India,2016

4. Late preterm infants: Birth outcomes and health care utilization in the first year;Mac Bird T;Pediatrics,2010

5. Antenatal corticosteroids for women at risk of preterm delivery;Gyamfi-Bannerman C;N Engl J Med,2016

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