Antenatal steroids at 37 weeks, does it reduce neonatal respiratory morbidity? A randomized trial

Abstract

Objective: To assess the effect of prophylactic corticosteroids administration at 37 weeks before term elective cesarean section (CS) in reducing neonatal respiratory morbidity and admission to neonatal intensive care unit (NICU).

Methods: This randomized trial was conducted focusing on women subjected to term elective CS. Women who were eligible for the study were divided into two groups. At 37 weeks' gestation; study group received two intramuscular doses of 12 mg dexamethasone 24 h apart, while the control group given the usual care without steroids. Outcome measures were adverse neonatal respiratory outcomes (respiratory distress syndrome (RDS) and transient tachypnea of the newborn (TTN)) and rates of admission to NICU.

Results: Neonates in the treatment group had lower overall incidence of respiratory distress morbidity 7.9% versus 23% when compared to the control group. The main morbidity was TTN (7% in study versus 19.6% in control group). There was significantly lower incidence of both mild and moderate degrees of respiratory distress in the study group (7 and 0.9%, respectively) compared to 17 and 5.3% in the control group. The most significant benefit of steroid administration was noted in those babies 37-37(+6) weeks.

Conclusion: Antenatal administration of steroids at 37 weeks appears to be beneficial in reducing neonatal respiratory morbidity in women undergoing elective term CS.

Keywords: Corticosteroids; RDS; TTN; elective CS.