title: Single versus multiple courses of antenatal betamethasone and neonatal outcome: a randomized controlled trial.
abstract: OBJECTIVE
  This study compared the beneficial and adverse neonatal effects of a single versus repeated courses of antenatal betamethasone.
  
  
  METHODS
  Tertiary care hospital
  
  
  METHODS
  Open labeled, randomized controlled trial.
  
  
  METHODS
  Pregnant women (26-33 weeks) at risk of preterm delivery, who received one course of antenatal betamethasone and remained undelivered for 7 days. Those with uncertain gestation, major malformations and frank chorioamnionitis were excluded.
  
  
  METHODS
  Subjects were randomized to receive weekly antenatal betamethasone until 34 weeks or no further betamethasone.
  
  
  METHODS
  Primary: incidence of severe respiratory distress syndrome (RDS). Secondary: incidence of non-severe RDS and other neonatal morbidity; birth weight, length and occipito-frontal circumference (OFC); and, development and growth at 6 mo corrected age.
  
  
  RESULTS
  38 subjects were allocated to each group. Severe RDS was similar in multiple and single course groups (7% vs. 3% respectively, P=0.34), as was incidence of other morbidity. Composite outcome of RDS and or death within 28 days tended to be less in multiple course group (P=0.07). Birth anthropometry was similar in the 2 groups. At 6 mo corrected age (n=44), weight and length were significantly lower in multiple course group (p=0.003 and P=0.007, respectively), whereas OFC was not different (P=0.1). There were no differences vis a vis neurodevelopmental outcomes.
  
  
  CONCLUSIONS
  A single course of antenatal betamethasone was as efficacious as multiple courses, with respect to prevention of neonatal morbidity. Multiple antenatal betamethasone courses have long-term adverse effects on infant weight and length growth, but not on OFC and neurodevelopment.
authors: Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors: Premasish
authors: P
authors: Mazumder
authors: Sourabh
authors: S
authors: Dutta
authors: Jaswinder
authors: J
authors: Kaur
authors: Anil
authors: A
authors: Narang
mesh_terms: D000022:Abortion, Spontaneous / Q000517:prevention & control*; D000886:Anthropometry; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology*; D012128:Respiratory Distress Syndrome / Q000453:epidemiology*
chemical_list: D000893:Anti-Inflammatory Agents; D001623:Betamethasone