Does antenatal steroids treatment prior to elective cesarean section at 34-37 weeks of gestation reduce neonatal morbidity? Evidence from a case control study

Arch Gynecol Obstet. 2018 Jan;297(1):101-107. doi: 10.1007/s00404-017-4557-8. Epub 2017 Oct 24.

Abstract

Objective: To determine whether antenatal corticosteroids administration prior to an elective cesarean section (ECS) at 34-37 weeks gestation is associated with improved neonatal outcome.

Materials and methods: A case control study of women with singleton pregnancies who underwent ECS between 34 and 37 weeks of gestation including two groups: (1) study group in which patients were treated with betamethasone prior to ECS (n = 58) and (2) control group matched for gestational age at delivery in which patients did not receive betamethasone (n = 107). Neonatal measures including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), oxygen requirement, admission to the special care unit, hypoglycemia, hyperbilirubinemia and length of hospitalization were determined in both groups. Composite respiratory morbidity was defined as the presence of either RDS, TTN, mechanical ventilation or oxygen requirement.

Results: There was no significant difference in the rate of composite respiratory morbidity nor its components between patients with and without betamethasone treatment (25.9 vs. 25.2%, respectively, p = 0.9).

Conclusion: Antenatal treatment with corticosteroids prior to ECS at 34-37 weeks of gestation did not result in significant reduction in neonatal respiratory morbidity in our cohort of patients.

Keywords: Antenatal corticosteroids; Elective cesarean section; Late prematurity; Neonatal morbidity.

MeSH terms

  • Adrenal Cortex Hormones / pharmacology
  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Case-Control Studies
  • Cesarean Section / methods*
  • Female
  • Humans
  • Infant
  • Infant Mortality / trends*
  • Infant, Newborn
  • Middle Aged
  • Pregnancy
  • Respiratory Distress Syndrome, Newborn / etiology

Substances

  • Adrenal Cortex Hormones