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Comparative Study
. 2007 Nov;197(5):523.e1-6.
doi: 10.1016/j.ajog.2007.04.004.

Betamethasone for lung maturation: testing dose and formulation in fetal sheep

Alan H Jobe  1 , Timothy J M Moss, Ilias Nitsos, Machiko Ikegami, Suhas G Kallapur, John P Newnham
Affiliations
Comparative Study

Betamethasone for lung maturation: testing dose and formulation in fetal sheep

Alan H Jobe et al. Am J Obstet Gynecol. 2007 Nov.

Abstract

Objective: We evaluated lung maturation responses to the mixture of betamethasone phosphate (Beta-PO4) + betamethasone acetate (Beta-Ac) in comparison to Beta-PO4 or Beta-Ac in fetal sheep.

Study design: Ewes carrying singleton pregnancies at 122 days of gestation were randomized to single doses of 0.5 mg/kg Beta-PO4 + Beta-Ac, 0.25 mg/kg Beta-PO4, 0.5 mg/kg Beta-PO4, or 0.25 mg/kg Beta-Ac given 48 hours before delivery. These treatments were compared with saline placebo and 2 doses of 0.5 mg/kg Beta-PO4 + Beta-Ac that were given 48 and 24 hours before delivery. Fetal lung maturation was evaluated.

Results: The 2 doses of the Beta-PO4 + Beta-Ac mixture gave the best lung maturation. Single doses of the Beta-PO4 + Beta-Ac mixture and Beta-Ac alone also induced lung maturation. There were no consistent responses to either dose of Beta-PO4.

Conclusion: Beta-PO4 alone is ineffective with the dosing schedule used; Beta-Ac can induce lung maturation. However, the best responses result from the mixture of Beta-PO4 + Beta-Ac.

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Figures

Fig. 1
Fig. 1
Compliance and ventilation efficiency index at 30 min of age. A. The 2 dose 0.5 mg/kg Beta-PO4 + Beta-Ac treatment increased compliance relative to control and all other groups. The single dose 0.5 mg/kg Beta-PO4 + Beta-Ac increased compliance relative to control by t-test. B. The ventilation efficiency index was increased by the single and two dose 0.5 mg/kg Beta-PO4 + Beta-Ac mixture relative to control, and the two dose treatment was different from all other treatments. The Beta-PO4 treatments had no effect on compliance or ventilation efficiency index, while the 0.25 mg/kg Beta-Ac increased ventilation efficiency index relative to control by t-test. * - different from control by ANOVA, 1 - different from all other groups by ANOVA, t - different from control by t-test.
Fig. 2
Fig. 2
Deflation limbs of pressure-volume curves measured after 30 min of ventilation. The curves for the 2 doses of 0.5 mg/kg Beta-PO4 + Beta-Ac (△), 1 dose of 0.5 mg/kg Beta-PO4 + Beta-Ac (▼), and 1 dose of 0.25 mg/kg Beta-Ac (▽) were different from the control curve (○), but not from each other. The 0.25 mg/kg Beta-PO4 (●) and 0.5 mg/kg Beta-PO4 (▲) curves were not different from control. Pressure-volume curves were measured for all control and Beta-PO4 treated animals, for 8 Beta-Ac treated animals, for 10 0.5 mg/kg Beta-PO4 + Beta-Ac × 1 treated animals, and for 7 0.5 mg/kg Beta-PO4 + Beta-Ac × 2 treated animals because some animals had air leaks caused by pulmonary interstitial emphysema. * - different from control by repeated measures ANOVA for the curves.
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References

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