Does Corticosteroids Administration after 37 Weeks for Elective Lower Segment Cesarean Section Reduce Neonatal Respiratory Morbidity? a Randomized Controlled Trial.

Abstract

Background: Cesarean delivery is a known risk factor for neonatal respiratory complications, mostly transient tachypnea of the newborn (TTN) and respiratory distress syndrome (RDS) in infants at or near term. The current study aimed to assess the efficacy of steroids administered before performing term (37-39 weeks), elective caesarean section in reducing neonatal respiratory morbidity and. Methods: This is a randomized controlled study which was done on Benha University Hospital and Benha Teaching Hospital, Egypt. Four hundred cases were divided into two groups. Group A (Steroid Group): included 200 cases who received two intramuscular (IM) doses of 12 mg dexamethasone 12 hours apart, 24 hours before elective CS. Group B (Control Group): included 200 cases who received IM saline as a placebo in the same regimen as the steroid group. Results: There was no statistically significant difference between group A and group B regarding maternal age, BMI, gravidity, mean number of previous C.S. birth weight and gestational age. Mean value of Apgar scores at 1 and 5 minutes was statistically significant higher among group A than group B.TTN was statistically significant lower among group A than group B. Admission to NICU was statistically significant lower among group A than group B. There was statistically significant higher numbers of neonates in group A than in group B regarding neonatal need for CPAP. Conclusion : Prophylactic intramuscular injection of 12 mg dexamethasone 12 hours apart, 24 hours before elective CS at gestational age of 37 to 39 weeks can reduce neonatal respiratory morbidity