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Antenatal Betamethasone for Women at Risk for Late Preterm Delivery.

Publication ,  Journal Article
Gyamfi-Bannerman, C; Thom, EA; Blackwell, SC; Tita, ATN; Reddy, UM; Saade, GR; Rouse, DJ; McKenna, DS; Clark, EAS; Thorp, JM; Chien, EK ...
Published in: N Engl J Med
April 7, 2016

BACKGROUND: Infants who are born at 34 to 36 weeks of gestation (late preterm) are at greater risk for adverse respiratory and other outcomes than those born at 37 weeks of gestation or later. It is not known whether betamethasone administered to women at risk for late preterm delivery decreases the risks of neonatal morbidities. METHODS: We conducted a multicenter, randomized trial involving women with a singleton pregnancy at 34 weeks 0 days to 36 weeks 5 days of gestation who were at high risk for delivery during the late preterm period (up to 36 weeks 6 days). The participants were assigned to receive two injections of betamethasone or matching placebo 24 hours apart. The primary outcome was a neonatal composite of treatment in the first 72 hours (the use of continuous positive airway pressure or high-flow nasal cannula for at least 2 hours, supplemental oxygen with a fraction of inspired oxygen of at least 0.30 for at least 4 hours, extracorporeal membrane oxygenation, or mechanical ventilation) or stillbirth or neonatal death within 72 hours after delivery. RESULTS: The primary outcome occurred in 165 of 1427 infants (11.6%) in the betamethasone group and 202 of 1400 (14.4%) in the placebo group (relative risk in the betamethasone group, 0.80; 95% confidence interval [CI], 0.66 to 0.97; P=0.02). Severe respiratory complications, transient tachypnea of the newborn, surfactant use, and bronchopulmonary dysplasia also occurred significantly less frequently in the betamethasone group. There were no significant between-group differences in the incidence of chorioamnionitis or neonatal sepsis. Neonatal hypoglycemia was more common in the betamethasone group than in the placebo group (24.0% vs. 15.0%; relative risk, 1.60; 95% CI, 1.37 to 1.87; P<0.001). CONCLUSIONS: Administration of betamethasone to women at risk for late preterm delivery significantly reduced the rate of neonatal respiratory complications. (Funded by the National Heart, Lung, and Blood Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development; ClinicalTrials.gov number, NCT01222247.).

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Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

April 7, 2016

Volume

374

Issue

14

Start / End Page

1311 / 1320

Location

United States

Related Subject Headings

  • Respiratory Tract Diseases
  • Respiration, Artificial
  • Pulmonary Surfactants
  • Pregnancy Trimester, Third
  • Pregnancy
  • Oxygen Inhalation Therapy
  • Obstetric Labor, Premature
  • Injections, Intramuscular
  • Infant, Premature, Diseases
  • Infant, Premature
 

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Gyamfi-Bannerman, C., Thom, E. A., Blackwell, S. C., Tita, A. T. N., Reddy, U. M., Saade, G. R., … NICHD Maternal–Fetal Medicine Units Network, . (2016). Antenatal Betamethasone for Women at Risk for Late Preterm Delivery. N Engl J Med, 374(14), 1311–1320. https://doi.org/10.1056/NEJMoa1516783
Gyamfi-Bannerman, Cynthia, Elizabeth A. Thom, Sean C. Blackwell, Alan T. N. Tita, Uma M. Reddy, George R. Saade, Dwight J. Rouse, et al. “Antenatal Betamethasone for Women at Risk for Late Preterm Delivery.N Engl J Med 374, no. 14 (April 7, 2016): 1311–20. https://doi.org/10.1056/NEJMoa1516783.
Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita ATN, Reddy UM, Saade GR, et al. Antenatal Betamethasone for Women at Risk for Late Preterm Delivery. N Engl J Med. 2016 Apr 7;374(14):1311–20.
Gyamfi-Bannerman, Cynthia, et al. “Antenatal Betamethasone for Women at Risk for Late Preterm Delivery.N Engl J Med, vol. 374, no. 14, Apr. 2016, pp. 1311–20. Pubmed, doi:10.1056/NEJMoa1516783.
Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita ATN, Reddy UM, Saade GR, Rouse DJ, McKenna DS, Clark EAS, Thorp JM, Chien EK, Peaceman AM, Gibbs RS, Swamy GK, Norton ME, Casey BM, Caritis SN, Tolosa JE, Sorokin Y, VanDorsten JP, Jain L, NICHD Maternal–Fetal Medicine Units Network. Antenatal Betamethasone for Women at Risk for Late Preterm Delivery. N Engl J Med. 2016 Apr 7;374(14):1311–1320.

Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

April 7, 2016

Volume

374

Issue

14

Start / End Page

1311 / 1320

Location

United States

Related Subject Headings

  • Respiratory Tract Diseases
  • Respiration, Artificial
  • Pulmonary Surfactants
  • Pregnancy Trimester, Third
  • Pregnancy
  • Oxygen Inhalation Therapy
  • Obstetric Labor, Premature
  • Injections, Intramuscular
  • Infant, Premature, Diseases
  • Infant, Premature