Antenatal Betamethasone Compared With Dexamethasone (Betacode Trial)

Abstract

Betamethasone and dexamethasone are comparable in reducing the rate of most major neonatal morbidities and mortality in preterm neonates. However, dexamethasone seems to be more effective in reducing the rate of intraventricular hemorrhage compared with betamethasone.

Differences in subependymal vein anatomy may predispose preterm infants to GMH–IVH

“…A clear relation among GMH–IVH, pneumothorax and arterial hypotension is well established. Moreover, it has been demonstrated that protection against cerebrovascular events in preterm neonates can be provided by prenatal administration of glucocorticoid, which decreases the severity of the respiratory distress and the incidence of GMH–IVH33 and stabilises the existing germinal matrix vasculature 34. Consistent with these studies, our multivariable logistic regression analysis demonstrated an association of GMH–IVH with pneumothorax, arterial hypotension and incomplete prenatal steroid administration 6…”

Antenatal Corticosteroids in the Management of Preterm Birth: Are We Back Where We Started?

“…52 However, neonates exposed to betamethasone had a significantly higher rate of IVH (17% vs 5.7%). It would appear that the randomized data tends to favor dexamethasone over betamethasone because of this reduction in IVH.…”

Preterm birth: An overview of risk factors and obstetrical management

“…In the study, 299 women at high risk for preterm delivery were randomized to receive either two doses of betamethasone, 12 mg 24 hr apart, or four doses of dexamethasone, 6 mg given 12 hr apart. The results showed that there was no statistically significant difference between the two groups in the rates of RDS, need for vasopressor therapy, necrotizing enterocolitis, retinopathy of prematurity, neonatal sepsis, patent ductus arteriosus, or neonatal death [Elimian et al, 2007]. Treatment with betamethasone and dexamethasone are equivalent in preventing neonatal morbidity and mortality; however, as betamethasone requires two rather than four injections, it is more commonly used in clinical practice.…”