TY - JOUR
T1 - The effect of corticosteroid therapy in the very premature infant
AU - The March of Dimes Multicenter Study Group
AU - Maher, James E.
AU - Cliver, Suzanne P.
AU - Goldenberg, Robert L.
AU - Davis, Richard O.
AU - Copper, Rachel L.
N1 - Funding Information:
Supported in part by the March of Dimes Birth Defects Foundation and by Agency for Health Care Policy and Research contract No. DHHS 282-92-0055.
PY - 1995
Y1 - 1995
N2 - OBJECTIVE: Our purpose was to determine the efficacy of maternal corticosteroid therapy between 26 and 31 weeks' gestation. STUDY DESIGN: The data in this study were derived from 32,658 women who participated in the March of Dimes - sponsored multicenter prematurity prevention program. Of the 432 women who were delivered at 26 to 31 weeks, 67 received betamethasone before delivery and 365 did not. The frequency and relative risks of adverse outcomes, including respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death were compared for each of two gestational age periods by means of univariate and multivariate techniques. RESULTS: When betamethasone was administered ≥2 days before delivery (n = 45), there was a lower incidence of respiratory distress syndrome in both the 26 to 28 week group (53.9% vs 86.5%, p = 0.008) and the 29 to 31 week group (25.0% vs 59.1%, p = 0.0003). The rate of intraventricular hemorrhage was less in the betamethasone group at 26 to 28 weeks (15.4% vs 32.3%, p = 0.17), but the difference reached statistical significance only at 29 to 31 weeks (3.1% vs 16.5%, p = 0.029). Neonatal death occurred significantly less often in infants who were delivered at 26 to 28 weeks when their mothers received betamethasone compared with infants of the same gestational age whose mothers did not receive betamethasone treatment (0% vs 34.6%, p = 0.01). In a regression analysis of infants born between 26 and 31 weeks in which birth weight, gestational age, race, infant sex, and tocolytic use were controlled, the odds ratio for respiratory distress syndrome associated with betamethasone use was 0.20 (0.10, 0.42), for intraventricular hemorrhage 0.26 (0.08, 0.90), and for neonatal death 0.14 (0.02, 1.09). Insufficient numbers of women were given betamethasone before 26 weeks for analysis. CONCLUSION: Betamethasone appears to significantly reduce neonatal death and the morbidity between 26 and 31 weeks' gestation. (AM J OBSTET GYNECOL 1994;170:869-73.)
AB - OBJECTIVE: Our purpose was to determine the efficacy of maternal corticosteroid therapy between 26 and 31 weeks' gestation. STUDY DESIGN: The data in this study were derived from 32,658 women who participated in the March of Dimes - sponsored multicenter prematurity prevention program. Of the 432 women who were delivered at 26 to 31 weeks, 67 received betamethasone before delivery and 365 did not. The frequency and relative risks of adverse outcomes, including respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, and neonatal death were compared for each of two gestational age periods by means of univariate and multivariate techniques. RESULTS: When betamethasone was administered ≥2 days before delivery (n = 45), there was a lower incidence of respiratory distress syndrome in both the 26 to 28 week group (53.9% vs 86.5%, p = 0.008) and the 29 to 31 week group (25.0% vs 59.1%, p = 0.0003). The rate of intraventricular hemorrhage was less in the betamethasone group at 26 to 28 weeks (15.4% vs 32.3%, p = 0.17), but the difference reached statistical significance only at 29 to 31 weeks (3.1% vs 16.5%, p = 0.029). Neonatal death occurred significantly less often in infants who were delivered at 26 to 28 weeks when their mothers received betamethasone compared with infants of the same gestational age whose mothers did not receive betamethasone treatment (0% vs 34.6%, p = 0.01). In a regression analysis of infants born between 26 and 31 weeks in which birth weight, gestational age, race, infant sex, and tocolytic use were controlled, the odds ratio for respiratory distress syndrome associated with betamethasone use was 0.20 (0.10, 0.42), for intraventricular hemorrhage 0.26 (0.08, 0.90), and for neonatal death 0.14 (0.02, 1.09). Insufficient numbers of women were given betamethasone before 26 weeks for analysis. CONCLUSION: Betamethasone appears to significantly reduce neonatal death and the morbidity between 26 and 31 weeks' gestation. (AM J OBSTET GYNECOL 1994;170:869-73.)
KW - Corticosteroid therapy
KW - neonatal outcome
KW - premature infant
KW - respiratory distress syndrome
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U2 - 10.1016/S0002-9378(94)70300-0
DO - 10.1016/S0002-9378(94)70300-0
M3 - Editorial
C2 - 8141218
AN - SCOPUS:0028358971
SN - 0002-9378
VL - 170
SP - 869
EP - 873
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 3
ER -