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

[ Vol. 14 , Issue. ]

Author(s):

Fatemeh Abbasalizadeh, Khadijeh Pouya, Raana Zakeri, Rana Asgari- Arbat*, Shamsi Abbasalizadeh and Neda Parnianfard Pages 1-6 (6)

Abstract:


Background: Neonatal Respiratory Distress Syndrome (NRDS) is one the most frequent causes of neonatal mortality especially in premature infants. Although it has been well established that maternal antenatal corticosteroids 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 incidence of NRDS in multifetal pregnancies through a randomized controlled trial.

Method: 140 women with a multifetal pregnancy at less than 28 weeks’ gestational age were randomly allocated into intervention and control groups. Women at 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: Although the occurrence of preterm birth didn’t differ between two study groups, the incidence of NRDS was significantly lower in infants of betamethasone group than the ones in control group (4.9% vs 18.1%, P=0.034) while it didn’t show a significant reduction in preterm infants compared to mature ones. Also, the intervention group presented a significant lower neonatal ventilation than control group (47.2% vs 63.2%, P=0.041). Other neonatal outcomes, including age at birth, gender, birthweight, Apgar score <7, NICU admission, 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

Affiliation:

Department of Obstetrics and Gynecology, School of Medicine, Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Department of Obstetrics and Gynecology, Ankara University School of Medicine, Ankara, Department of Health Services Management, School of Management and Medical Informatics, Iranian International Safe Community Support Center, Tabriz University of Medical Sciences, Tabriz, Department of Obstetrics and Gynecology, School of Medicine, Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Department of Obstetrics and Gynecology, School of Medicine, Women’s Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Research Center for Evidence-Based Medicine, Drug Applied Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz



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