Corticosteroids Administration at Term to Prevent Neonatal Respiratory Morbidity: A Randomized Controlled Trial
Mohamed Magdy Shafeek Salem;
Abstract
Summary
I
nfants born at term by elective caesarean delivery are more likely to develop respiratory morbidity than infants born vaginally. Prophylactic corticosteroids in singleton preterm pregnancies accelerate lung maturation and reduce the incidence of respiratory complications (Sotiridis et al., 2009).
Antenatal betamethasone is effective in reducing admission to special care baby unit with respiratory distress after elective caesarean section at term (Stutchfield et al., 2005).
The objective of this study is to assess the effect of prophylactic corticosteroid administration before elective caesarean section at term (between 38wks and 38+6), in reducing neonatal respiratory morbidity and admission to special care units with respiratory complications.
Design: Prospective randomized study.
Methodology: 2 groups; (Group A) which consists of 645 patients who received prophylactic cortecosteroid and (Groups B) 645 patients who received placebo before elective caesarean section.
The treatment group received 3 intramuscular doses of 8 mg dexamethasone 8 hours apart 24-48 hours before delivery. The control group received placebo in the same dosage.
Outcome measures:
The Primary outcome was admission to neonatal intensive care unit (NICU) with respiratory complications. Secondary outcome was severity of respiratory distress and level of care in response.
There were no significant differences between women of both groups regarding neonatal gender, birth weight, 1-min and 5-min Apgar scores
The rate of admission to neonatal intensive care unit (NICU) for respiratory morbidity was significantly lower in group I [Dexamethasone Group] when compared to group II [Control Group]].
The rate of neonatal admission to primary care baby unit (PCBU) and TTN was significantly lower in group I [Dexamethasone Group] when compared to group II [Control Group].
There was a statistically no significant difference between both groups of RDS.
There was a statistically no significant difference between both groups regarding need for mechanical ventilation.
There was 3 cases of neonatal mortality in both groups with no statistical significant difference.
I
nfants born at term by elective caesarean delivery are more likely to develop respiratory morbidity than infants born vaginally. Prophylactic corticosteroids in singleton preterm pregnancies accelerate lung maturation and reduce the incidence of respiratory complications (Sotiridis et al., 2009).
Antenatal betamethasone is effective in reducing admission to special care baby unit with respiratory distress after elective caesarean section at term (Stutchfield et al., 2005).
The objective of this study is to assess the effect of prophylactic corticosteroid administration before elective caesarean section at term (between 38wks and 38+6), in reducing neonatal respiratory morbidity and admission to special care units with respiratory complications.
Design: Prospective randomized study.
Methodology: 2 groups; (Group A) which consists of 645 patients who received prophylactic cortecosteroid and (Groups B) 645 patients who received placebo before elective caesarean section.
The treatment group received 3 intramuscular doses of 8 mg dexamethasone 8 hours apart 24-48 hours before delivery. The control group received placebo in the same dosage.
Outcome measures:
The Primary outcome was admission to neonatal intensive care unit (NICU) with respiratory complications. Secondary outcome was severity of respiratory distress and level of care in response.
There were no significant differences between women of both groups regarding neonatal gender, birth weight, 1-min and 5-min Apgar scores
The rate of admission to neonatal intensive care unit (NICU) for respiratory morbidity was significantly lower in group I [Dexamethasone Group] when compared to group II [Control Group]].
The rate of neonatal admission to primary care baby unit (PCBU) and TTN was significantly lower in group I [Dexamethasone Group] when compared to group II [Control Group].
There was a statistically no significant difference between both groups of RDS.
There was a statistically no significant difference between both groups regarding need for mechanical ventilation.
There was 3 cases of neonatal mortality in both groups with no statistical significant difference.
Other data
| Title | Corticosteroids Administration at Term to Prevent Neonatal Respiratory Morbidity: A Randomized Controlled Trial | Other Titles | دور الكورتيزون قبل الولادة القيصرية المخطط لها عند نضوج الجنين لمنع الأزمات التنفسية | Authors | Mohamed Magdy Shafeek Salem | Issue Date | 2014 |
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