Fetal and neonatal outcomes after term and preterm delivery following betamethasone administration

Thorsten Braun; Deborah M Sloboda; Boris Tutschek; Thomas Harder; John R G Challis; Joachim W Dudenhausen; Andreas Plagemann; Wolfgang Henrich

doi:10.1016/j.ijgo.2015.01.013

Fetal and neonatal outcomes after term and preterm delivery following betamethasone administration

Int J Gynaecol Obstet. 2015 Jul;130(1):64-9. doi: 10.1016/j.ijgo.2015.01.013. Epub 2015 Mar 31.

Authors

Thorsten Braun¹, Deborah M Sloboda², Boris Tutschek³, Thomas Harder⁴, John R G Challis⁵, Joachim W Dudenhausen⁴, Andreas Plagemann⁴, Wolfgang Henrich⁴

Affiliations

¹ Departments of Obstetrics and Division of Experimental Obstetrics, Study Group Perinatal Programming, Charité Campus Virchow, Berlin, Germany. Electronic address: [email protected].
² Departments of Biochemistry and Biomedical Sciences, Obstetrics and Gynecology and Pediatrics, McMaster University, Hamilton, ON, Canada.
³ Medical Faculty Heinrich Heine University, Düsseldorf, Germany.
⁴ Departments of Obstetrics and Division of Experimental Obstetrics, Study Group Perinatal Programming, Charité Campus Virchow, Berlin, Germany.
⁵ Department of Physiology, Obstetrics and Gynecology, University of Toronto, Toronto, ON, Canada; Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada; Departments of Obstetrics and Gynecology, University of Western Australia, Perth, WA, Australia.

PMID: 25872453
DOI: 10.1016/j.ijgo.2015.01.013

Abstract

Objective: To determine the effects of betamethasone on fetal growth and neonatal outcomes.

Methods: A retrospective cohort study was performed of deliveries that occurred at Charité University Hospital Berlin, Germany, between January 1996 and December 2008. The betamethasone group included women with preterm labor and symptomatic contractions, cervical insufficiency, preterm premature rupture of membranes, or vaginal bleeding. Women in the control group were matched for gestational age at time of delivery and had not received betamethasone. Fetal growth changes and neonatal anthropometry were compared.

Results: Among 1799 newborns in the betamethasone group and 42 240 in the control group, betamethasone was associated with significantly lower birth weight (154 g lower on average) after adjusting for confounders (e.g. hypertension, smoking, and maternal weight), sex, and gestational age at delivery (P<0.05). The higher the dose, the greater the difference in mean birth weight versus controls in births before 34(+0)weeks (≤16 mg -444 g; 24 mg -523 g; >24 mg -811 g), without a detectable improvement in neonatal morbidity or mortality. There was a dose-dependent decline in expected fetal weight gain as estimated by serial ultrasonography examinations 6-8 weeks after betamethasone administration (P<0.05).

Conclusion: Betamethasone exposure reduces fetal weight gain in a dose-dependent manner without improving neonatal morbidity or mortality.

Keywords: Betamethasone; Birth weight; Dose; Glucocorticoid; Sex.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Betamethasone / administration & dosage*
Birth Weight
Delivery, Obstetric
Female
Fetal Development / drug effects*
Fetal Membranes, Premature Rupture / drug therapy
Germany
Gestational Age
Glucocorticoids / administration & dosage*
Humans
Infant, Newborn
Male
Pregnancy
Pregnancy Outcome*
Premature Birth / drug therapy*
Respiratory Distress Syndrome, Newborn / drug therapy
Retrospective Studies
Term Birth / drug effects*

Substances

Glucocorticoids
Betamethasone