Effect of antenatal corticosteroids in late preterm delivery on neonatal
morbidity: A Randomised Controlled Trial
Abstract
Objective: The use of antenatal corticosteroids beyond 34 weeks of
gestation remains a debate. This study sought to determine the effect of
use of antenatal corticosteroids in late preterm delivery on neonatal
morbidity. Design: It was a randomized double-blind placebo and active
controlled multi arm trial. There were two study groups and one control
group. Setting: It was conducted at the department of Obstetrics and
Gynaecology and the Department of Paediatrics of Ahmadu Bello University
Teaching Hospital Zaria. Population: Pregnant women at 34 weeks 0 days
to 36 weeks 6 days of gestation scheduled for elective/emergency
delivery were recruited for the study. Methods: The study groups had
dexamethasone and betamethasone respectively while the control group had
a placebo. Main outcome: The primary outcome was incidence of
respiratory distress syndrome. Results: A total of 138 mothers and 146
preterm neonates were included in the study with 48 exposed to placebo,
49 exposed to betamethasone and 49 exposed to dexamethasone. A pairwise
analysis was done to test for difference between the groups. There was
no statistically significant difference in the incidence of respiratory
distress syndrome between the dexamethasone vs placebo (p= 0.98, RR 1,
CI 0.06-16.89), betamethasone vs placebo (p= 0.98 RR 1, CI 0.09-11.55)
and dexamethasone vs betamethasone (p=0.32, RR 0.5, CI 0.09-2.42)
Conclusion: Antenatal corticosteroids may decrease the need for neonatal
resuscitation at birth in late preterm neonates.