ARTICLE INFO

Article Type

Original Research

Authors

Saymari   F. (1 )
Zand Vakili   F. (* )
Rezaie   M. (1 )
Mansori   M. (2 )
Afkhamzadeh   A. (3 )






(* ) Obstetrics & Gynecology Department, Medicine Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran
(1 ) Obstetrics & Gynecology Department, Medicine Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran
(2 ) Pediatrics Department, Medicine Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran
(3 ) Family & Social Medicine Department, Medicine Faculty, Kurdistan University of Medical Sciences, Sanandaj, Iran

Correspondence

Address: Obstetrics & Gynecology Department, Be’sat Hospital, Mardoukh Junction, Keshavarz Street, Sanandaj, Iran
Phone: +988733288119
Fax: +988733288119
fr.fzandvakili@gmail.com

Article History

Received:   December  22, 2014
Accepted:   March 1, 2015
ePublished:   April 16, 2015

ABSTRACT

Aims The use of corticosteroids and abandoning the delivery are of preventive actions of newborns’ respiratory distress syndrome. The aim of this clinical trial was to compare the effect of one versus two doses of Betamethasone on the outcomes of preterm infants.
Materials & Methods In this quasi-experimental clinical trial, 100 preterm labor pregnant women who referred to Sanandaj Be’sat Hospital in 2013 were selected by purposive sampling method and were divided into one dose (12mg Betamethasone) and two doses (12mg Betamethasone with the interval of 24 hours) groups. Information about delivery and gender, weight and Apgar scores of newborn were recorded in the checklist. Newborns were examined for infant respiratory distress syndrome, necrotizing enterocolitis, cerebral hemorrhage and neonatal death. Data were analyzed in SPSS 20 software by Chi-square and Mann-Whitney U tests.
Findings 14 newborns (28%) in one dose and 13 (24.5%) in two doses group had respiratory distress syndrome (p=0.689). 4 newborns (8%) in one dose and 7 (13.2%) in two doses group had enterocolitis and 8 newborns (16%) in one dose and 9 (17%) in two doses group needed respiratory support (p>0.05).
Conclusion Single-dose or two doses administration of Betamethasone in preterm mothers have no impact on newborn after birth.


CITATION LINKS

[1]Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Williams obstetrics. 23rd edition. New York: McGraw-Hill Professional; 2009. p. 819.
[2]Gamsu HR, Mullinger BM, Donnai P, Dash CH. Antenatal administration of betamethasone to prevent respiratory distress syndrome in preterm infants: Report of a UK multicentre trial. Br J Obstet Gynaecol. 1989;96(4):401-10.
[3]Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation: A reference guide to fetal and neonatal risk . 4th edition. Baltimore: Williams & Wilkins; 1994. pp. 89- 90.
[4]Vermillion ST, Soper DE, Newman RB. Neonatal sepsis and death after multiple courses of antenatal betamethasone therapy. Am J Obstet Gynecol. 2000;183(4):810-4.
[5]Esplin MS, Fausett MB, Smith S, Oshiro BT, Porter TF, Brancb DW, Varner MW. Multiple courses of antenatal steroids are associated with a delay in long-term Psychomotor development in children with birth weights<1500 grams. Am J Obstet Gynecol. 2000;182:S24.
[6]Rodriguez RJ, Martin RJ, Fanaroff AA. Respiratory distress syndrome and its management. In: Fanaroff AA, Martin RJ, editors. Neonatal-perinatal medicine: Diseases of the fetus and infant. 8th edition. Mosby; 2006. pp. 1001-11.
[7]Meneguel JF, Guinsburg R, Miyoshi MH, de Araujo Peres C, Russo RH, Kopelman BI, et al. Antenatal treatment with corticosteroids for preterm neonates: impact on the incidence of respiratory distress syndrome and intra-hospital mortality. Sao Paulo Med J. 2003;121(2):45-52.
[8]Dudell GG, Stoll BJ. Respiratory tract disorders. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics. 18th edition. Philadelphia: Saunders; 2007. pp. 728-53.
[9]Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev. 2000;(2):CD000065.
[10]Crowley P, Chalmers I, Keirse MJ. The effects of corticosteroid administration before preterm delivery: An overview of the evidence from controlled trials. Br J Obstet Gynaecol. 1990;97(1):11-25.
[11]Asnafei N, Pourreza R, Miri SM. Pregnancy outcome in premature delivery of between 34-37 weeks and the effects of corticosteroid on it. J Gorgan Univ Med Sci. 2004;6(2):57-60. [Persian]
[12]Goldenberg RL. The management of preterm labor. Obstet Gynecol. 2002;100(5Pt1):1020-37.
[13]Schmitt BD. Instructions for pediatric patients.2nd edition. Philadelphia: Saunders; 1999.
[14]Mansouri M, Seyedolshohadaei F, Company F, Setare Sh, Mazhari S. Effect of antenatal Betamethasone on prevention of respiratory distress syndrome among neonates with gestational age of 35-36 weeks. J Gorgan Univ Med Sci. 2010;12(3):18-23. [Persian]
[15]Dalziel SR, Walker NK, Parag V, Mantell C, Rea HH, Rodgers A, et al. Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial. Lancet. 2005;365(9474):1856-62.
[16]Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consens Statement. 1994;12(2):1-24.
[17]Wang YC, Tseng HI, Yang SN, Lu CC, Wu JR, Dai ZK, et al. Effects of antenatal corticosteroids on neonatal outcomes in very-low-birth-weight preterm newborns: A 10-year retrospective study in a medical center. Pediatr Neonatol. 2012;53(3):178-83.
[18]Khandelwal M, Chang E, Hansen C, Hunter K, Milcarek B. Betamethasone dosing interval: 12 or 24 hours apart? A randomized, noninferiority open trial. Am J Obstet Gynecol. 2010;206(3):e1-11.
[19]Fekih M, Chaieb A, Sboui H, Denguezli W, Hidar S, Khairi H. Value of prenatal corticotherapy in the prevention of hyaline membrane disease in premature infants. Randomized prospective study. Tunis Med. 2002;80(5):260-5. [French]
[20]Nanbakhsh F, Mohadesi H, Ordokhani A, Ghaderi J. Effects of dexamethasone injection on pregnancy outcome in preterm labor. Scientific J Hamadan Nurs Midwifery Fac. 2011;19(2):5-15. [Persian]
[21]Bontis N, Vavilis D, Tsolakidis D, Goulis DG, Tzevelekis P, Kellartzis D, et al. Comparison of single versus multiple courses of antenatal betamethasone in patients with threatened preterm labor. Clin Exp Obstet Gynecol. 2011;38(2):165-7.
[22]Bonanno C, Wapner RJ. Antenatal corticosteroids in the management of preterm birth: are we back where we started? Obstet Gynecol Clin North Am. 2012;39(1):47-63.
[23]Kliegman RM, Stanton BMD, Geme JSt, Schor N, Behrman RE. Nelson textbook of pediatrics. 19th edition. Philadelphia: Saunders; 2011.
[24]Crowley PA. Antenatal corticosteroid therapy: A meta-analysis of the randomized trials, 1972 to 1994. Am J Obstet Gynecol. 1995;173(1):322-35.
[25]Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2006; 19(3):CD004454.
[26]Moravedji Asl M, Kashanian M, Ahangari Shirzi A. The incidence of respiratory distress syndrome in preterm infants born during the first 24 hours of dexamethasone administration to mothers. Razi J Med Sci. 2005;12(45):173-80. [Persian]
[27]Nayeri F, Movaghar-Nezhad K, Assar-Zadegan F. Effects of antenatal steroids on the incidence and severity of respiratory distress syndrome in an Iranian hospital. East Mediterr Health J. 2005;11(4):716-22.
[28]Ventolini G, Neiger R, Mathews L, Adragna N, Belcastro M. Incidence of respiratory disorders in neonates born between 34 and 36 weeks of gestation following exposure to antenatal corticosteroids between 24 and 34 weeks of gestation. Am J Perinatol. 2008;25(2):79-83.
[29]Costa S, Zecca E, De Luca D, De Carolis MP, Romagnoli C. Efficacy of a single dose of antenatal corticosteroids on morbidity and mortality of preterm infants. Eur J Obstet Gynecol Reprod Biol. 2007;131(2):154-7.
[30]Peltoniemi OM, Kari MA, Tammela O, Lehtonen L, Marttila R, Halmesmäki E, et al. Randomized trial of a single repeat dose of prenatal betamethasone treatment in imminent preterm birth. Pediatri. 2007;119(2):290-8.
[31]Abbasi S, Hirsch D, Davis J, Tolosa J, Stouffer N, Debbs R, et al. Effect of single versus multiple courses of antenatal corticosteroids on maternal and neonatal outcome. Am J Obstet Gynecol. 2000;182(5):1243-9.
[32]Mazumder P, Dutta S, Kaur J, Narang A. Single versus multiple courses of antenatal betamethasone and neonatal outcome: A randomized controlled trial. Indian Pediatr. 2008;45(8):661-7.
[33]Ay H, Tosun M, Malatyalıoğlu E, Aygün C, Çetinkay MB, Çelik H. Comparison of single and double courses of antenatal corticosteroid administration on neonatal mortality and morbidity. J Turkish Ger Gynecol Assoc. 2010;11(1):38-43.