Antenatal Betamethasone for Women at Risk for Late Preterm Delivery

Gyamfi-Bannerman, Cynthia; Thom, Elizabeth; Tita, Alan T.N.; Reddy, Uma M.; Saade, George R.; Rouse, Dwight J.; McKenna, David S.; Clark, Erin A.S.; Thorp, John M.; Chien, Edward K.; Peaceman, Alan M.; Gibbs, Ronald S.; Swamy, Geeta K.; Norton, Mary E.; Casey, Brian M.; Caritis, Steve N.; Tolosa, Jorge E.; Sorokin, Yoram; VanDorsten, J. Peter; Jain, Lucky

doi:10.1097/01.ogx.0000489576.69844.54

Cited by 129 publications

(272 citation statements)

References 6 publications

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“…Maternal hyperglycemia will cause hypoglycemia in newborns, which increased from 15% to 24% in a trial of ACS for late preterm pregnancies. 25 In low resource environments, newborn hypoglycemia may not be effectively monitored or treated, and may cause neurodevelopmental injury. 26,27 Short-term use of oral corticosteroids is frequent worldwide with underappreciated risks of sepsis, venous thrombosis, and fracture.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India

Jobe

Milad²,

Peppard

et al. 2019

Clinical Translational Sci

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High‐dose betamethasone and dexamethasone are standard of care treatments for women at risk of preterm delivery to improve neonatal respiratory and mortality outcomes. The dose in current use has never been evaluated to minimize exposures while assuring efficacy. We report the pharmacokinetics and pharmacodynamics (PDs) of oral and intramuscular treatments with single 6 mg doses of dexamethasone phosphate, betamethasone phosphate, or a 1:1 mixture of betamethasone phosphate and betamethasone acetate in reproductive age South Asian women. Intramuscular or oral betamethasone has a terminal half‐life of 11 hours, about twice as long as the 5.5 hours for oral and intramuscular dexamethasone. The 1:1 mixture of betamethasone phosphate and betamethasone acetate shows an immediate release of betamethasone followed by a slow release where plasma betamethasone can be measured out to 14 days after the single dose administration, likely from a depo formed at the injection site by the acetate. PD responses were: increased glucose, suppressed cortisol, increased neutrophils, and suppressed basophils, CD3CD4 and CD3CD8 lymphocytes. PD responses were comparable for betamethasone and dexamethasone, but with longer times to return to baseline for betamethasone. The 1:1 mixture of betamethasone phosphate and betamethasone acetate caused much longer adrenal suppression because of the slow release. These results will guide the development of better treatment strategies to minimize fetal and maternal drug exposures for women at risk of preterm delivery.

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India

Jobe

Milad²,

Peppard

et al. 2019

Clinical Translational Sci

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“…20 Keeping with our results, a recent study in 2016 by Gyamfi-Bannerman and colleagues confirmed that administration of betamethasone to women at 34-36 weeks gestation significantly reduced the rate of TTN and surfactant use. 21 The main strength of the current study was the use of dexamethasone which is inexpensive, has no major side effects or complications, and has proven benefits. The large sample size of included women in the current study is another merit.…”

Section: Dexamethasone Before Elective Cesarean Section At Termmentioning

confidence: 99%

Dexamethasone for the prevention of neonatal respiratory morbidity before elective cesarean section at term

Salem

Abbas

Ashry

2016

Proc Obstet Gynecol

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“…Furthermore, recent study indicated that antenatal corticosteroids are also effective in late preterm neonates (between 34 to 36 weeks) (29). The caesarean section rate was high comparing to WHO recommendation to be between 10-15% (30), controversially majority of the babies who died in this study were born by caesarian section compared to those born by normal delivery.…”

Section: Mother's Related Factorsmentioning

confidence: 78%

Factors contributing to morbidity and mortality among preterm neonates admitted at two major hospitals in Rwanda

Muhayimana¹

2017

Research Journal of Health Sciences

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stObjective: Prematurity is one of the highest global health challenges of the 21 century and has been named the first killer of young children. In Rwanda, it is the leading cause of death in neonates. It is expedient to explore the factors contributing to the observed high morbidity and mortality to plan appropriate interventions. The objective of the study was to identify factors contributing to morbidity and mortality among preterm neonates and neonatal outcomes at discharge. Methods:Adopting the descriptive design and quantitative approach, 125 preterm babies admitted in the Neonatal Intensive Care Unit (NICU) of the University Teaching Hospital of Kigali and Muhima hospital over ten weeks were recruited in the study using consecutive sampling method. Interviewer administered questionnaire to the mothers, files of mothers and babies were used as sources of data. Frequencies, chisquare, and logistic regression were used for analysis. A p-value <0.05 was considered significant. Results:Marital status of mothers, mother's participation in the care of her baby, and APGAR score 6 with a p-value (0.007), (0.02), (0.002) respectively, were statistically significantly associated with mortality. Controlling for confounders, neonates with APGAR score 6 had a lower odds of dying compared to those with an APGAR score 6 (OR=0.268 CI:0.102,0.700). Morbidities and mortality was high as gestational age, and birth weight decreased. The main morbidities were neonatal sepsis (88.8%), and Respiratory Distress Syndrome (RDS) (62.4%). Conclusion:Mothers social background, participation in care, low apgar score and birth weights are critical factors with neonatal sepsis and RDS accounting for highest morbidities in preterm care. Morbidity and mortality among pre-term neonates in Rwanda Muhayimana A. Facteurs contribuant à la morbidité et la mortalité chez les nouveau-nés prématurés admis dans deux grands hôpitaux du RwandaMuhayimana A.Resume Objectif: La prématurité est l'un des plus grands défis de santé mondiale du 21ème siècle et a été nommé le premier tueur de jeunes enfants. Au Rwanda, c'est la principale cause de décès chez les nouveau-nés. Il est opportun d'explorer les facteurs contribuant à la morbidité et la mortalité élevées observées pour planifier des interventions appropriées. L'objective de cette etude etait identifier les facteurs contribuant à la morbidité et à la mortalité chez les nouveau-nés prématurés et les résultats néonatals à la sortie.Méthode: Adoptant la conception descriptive et l'approche quantitative, 125 bébés prématurés admis dans l'unité néonatale de soins intensifs (UNSI) de l'hôpital universitaire de Kigali et de l'hôpital Muhima pendant dix semaines ont été recrutés dans l'étude en utilisant une méthode d'échantillonnage consécutive. Questionnaire administré aux mères, les dossiers des mères et des bébés ont été utilisés comme sources de données. Les fréquences, le chi carré et la régression logistique ont été utilisés pour l'analyse. Une valeur p <0,05 était considérée comme significat...

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Antenatal Betamethasone for Women at Risk for Late Preterm Delivery

Cited by 129 publications

References 6 publications

Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India

Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India

Dexamethasone for the prevention of neonatal respiratory morbidity before elective cesarean section at term

Factors contributing to morbidity and mortality among preterm neonates admitted at two major hospitals in Rwanda

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