Short-Term Outcomes in Low Birth Weight Infants Following Antenatal Exposure to Betamethasone Versus Dexamethasone

Bar-Lev, Michal R. Rozenfeld MD*; Maayan-Metzger, Ayala MD*; Matok, Ilan MSc†; Heyman, Zahava MD‡; Sivan, Eyal MD§; Kuint, Jacob MD*

Obstetrics & Gynecology:
doi: 10.1097/01.AOG.0000137351.71015.ac
Original Research
Abstract

OBJECTIVE: To assess the incidence of short-term outcomes of low birth weight infants (≤ 1,750 g) exposed prenatally to either dexamethasone or betamethasone.

METHODS: We retrospectively analyzed a cohort comprising 550 infants who were born alive at our center during the period January 1999 through December 2001, who weighed 1,750 g or less at birth, and who were exposed to prenatal steroid treatment. We compared brain ultrasound findings, such as intraventricular hemorrhage and cystic periventricular leukomalacia (PVL), as well as other clinical findings, including respiratory distress syndrome (RDS), necrotizing enterocolitis, retinopathy of prematurity, and bronchopulmonary dysplasia, for all premature infants whose mothers received either dexamethasone (from January 1, 1999 to June 30, 2000, n = 263) or betamethasone (July 1, 2000 to December 31, 2001, n = 287).

RESULTS: Patient characteristics (mothers and infants) were the same in both groups, with the exception of the number of steroid courses administered, the number of women with premature rupture of membranes (defined as > 24 hours), and the number of women who had received tocolysis. No significant difference was found between the 2 groups with respect to intraventricular hemorrhage and cystic PVL frequencies. No significant differences were found in the incidence of short-term outcomes examined, despite the fact that the dexamethasone group was exposed to a statistically significantly greater number of courses than the betamethasone group.

CONCLUSION: There seem to be no advantages to maternal antenatal treatment with betamethasone compared with dexamethasone in reducing the risk of PVL in low birth weight (≤ 1,750 g) infants. Both drugs have the same effect on all short-term outcome parameters checked.

LEVEL OF EVIDENCE: II-2

In Brief

There are no advantages to maternal antenatal treatment with betamethasone compared with dexamethasone with respect to short-term neonatal outcomes.

Author Information

From the *Department of Neonatology, The Edmond and Lily Safra Children’s Hospital; †Department of Pharmacy Services, ‡Radiology Department, and §Department of Obstetrics and Gynecology, Sheba Medical Center and Sackler School of Medicine, Tel Aviv University, Israel.

Received March 26, 2004. Received in revised form May 19, 2004. Accepted June 3, 2004.

Address reprint requests to: Jacob Kuint, MD, Department of Neonatology, Sheba Medical Center 52621, Ramat Gan, Israel; e-mail: kuint-j@sheba.health.gov.il.

© 2004 The American College of Obstetricians and Gynecologists