Comparative study of dexamethasone and betamethasone for women at risk of preterm birth
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20150414Keywords:
Dexamethasone, Betamethasone, Neonatal outcomeAbstract
Background: Prematurity represents a serious problem for healthcare services throughout the world. Respiratory distress syndrome, neonatal death, intra-ventricular hemorrhage and low birth weight are continues to be the serious problems during the neonatal period, affecting a large number of premature infants. Dexamethasone and betamethasone are the two antenatal corticosteroids recommended for accelerating fetal lung development in threatened preterm birth.
Methods: This is a prospective comparative study conducted in the Department of Obstetrics and Gynecology, at Hiram Hospital, a tertiary care center situated in the rural area of Vadodara, in which 100 pregnant women of gestational age between 24 and 34 weeks with risk of preterm birth were taken as candidates for antenatal treatment with corticosteroids. Ethical approval was taken from the institutional ethical committee. Informed consent was taken from the patients. A detailed history and examination was done. 100 pregnant women of gestational age between 24 and 34 weeks with risk of preterm birth were selected randomly and divided into 2 groups of 50 each. Group A was given injection of dexamethasone 6mg intramuscularly 12 hours apart. Group B was given injection of betamethasone 12mg intramuscularly 24hours apart. Patients were observed for neonatal death, respiratory distress syndrome, intra-ventricular hemorrhage and low birth weight.
Results: In our study there was no significant difference between the two groups in rate of neonatal mortality (4% v/s 4%) and respiratory distress syndrome (38% v/s 40%). However, the rates of intra-ventricular hemorrhage (6% v/s 12%) and low birth weight (52% v/s 62%) were significantly low in neonates exposed to dexamethasone compared with betamethasone.
Conclusions: Dexamethasone is recommended over betamethasone for its efficacy, safety, wide availability and low cost for treatment of women at risk of preterm delivery.Metrics
References
Lee MJ, Guinn D. Antenatal use of glucocorticoids in women at risk for preterm delivery. Up-to-date journal 2015.
Derks JB, Giussani DA, Van Dam LM, Jenkins SL, Winter JA, Zhao XF, et al. Differential effects of betamethasone and dexamethasone fetal administration of parturition in sheep. J Soc Gynecol Investig. 1996;3:336–41.
Buttgereit F, Brand MD, Burmester GR. Equivalent doses and relative drug potencies for non-genomic glucocorticoid effects: a novel glucocorticoid hierarchy. Biochem Pharmacol. 1999;58:363–8.
Subtil D, Tiberghien P, Devos P, Therby D, Leclerc G, Vaast P, et al. Immediate and delayed effects of antenatal corticosteroids on fetal heart rate: a randomized trial that compares betamethasone acetate and phosphate, betamethasone phosphate, and dexamethasone. American Journal of Obstetrics and Gynecology. 2003;188(2):524–31.
Subtil D, Tiberghien P, Leclercq G, Therby D, Dufour P, Puech F. Randomized trial comparing three different forms of antenatal corticotherapy on fetal heart rate. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2002;104:179.
Chen CY, Wang KG, Chang TY, Chen CP. Effects of antenatal betamethasone and dexamethasone in preterm neonates. Taiwanese Journal of Obstetrics and Gynaecology. 2005;44(3):247–51.
Elimian A, Garry D, Figueroa R, Spitzer A, Wiencek V. Antenatal betamethasone compared with dexamethasone (Betacode Trial): a randomized controlled trial. Obstetrics and Gynecology. 2007;110(1):26–30.
Elimian A, Garry D, Figueroa R, Spitzer AR, Wiencek V, Ogburn P, et al.’Betacode Trial’ antenatal betamethasone compared to dexamethasone: a randomized controlled trial. American Journal of Obstetrics and Gynecology. 2005;193(6 Suppl):S5.
Brownfoot FC, Crowther CA, Middleton P. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2008, Issue 4. [DOI:10.1002/14651858.CD006764.pub2]
Brownfoot FC, Crowther CA, Middleton P. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2013, Issue 8.
