Antenatal betamethasone for women at risk for late preterm delivery

C. Gyamfi-Bannerman, E. A. Thom, S. C. Blackwell, A. T N Tita, U. M. Reddy, George Saade, D. J. Rouse, D. S. McKenna, E. A S Clark, J. M. Thorp, E. K. Chien, A. M. Peaceman, R. S. Gibbs, G. K. Swamy, M. E. Norton, B. M. Casey, S. N. Caritis, J. E. Tolosa, Y. Sorokin, J. P. Van Dorsten & 1 others L. Jain

    Research output: Contribution to journalArticle

    185 Citations (Scopus)

    Abstract

    BACKGROUND: Infants who are born at 34 to 36 weeks of gestation (late preterm) are at greater risk for adverse respiratory and other outcomes than those born at 37 weeks of gestation or later. It is not known whether betamethasone administered to women at risk for late preterm delivery decreases the risks of neonatal morbidities. METHODS: We conducted a multicenter, randomized trial involving women with a singleton pregnancy at 34 weeks 0 days to 36 weeks 5 days of gestation who were at high risk for delivery during the late preterm period (up to 36 weeks 6 days). The participants were assigned to receive two injections of betamethasone or matching placebo 24 hours apart. The primary outcome was a neonatal composite of treatment in the first 72 hours (the use of continuous positive airway pressure or high-flow nasal cannula for at least 2 hours, supplemental oxygen with a fraction of inspired oxygen of at least 0.30 for at least 4 hours, extracorporeal membrane oxygenation, or mechanical ventilation) or stillbirth or neonatal death within 72 hours after delivery. RESULTS: The primary outcome occurred in 165 of 1427 infants (11.6%) in the betamethasone group and 202 of 1400 (14.4%) in the placebo group (relative risk in the betamethasone group, 0.80; 95% confidence interval [CI], 0.66 to 0.97; P = 0.02). Severe respiratory complications, transient tachypnea of the newborn, surfactant use, and bronchopulmonary dysplasia also occurred significantly less frequently in the betamethasone group. There were no significant between-group differences in the incidence of chorioamnionitis or neonatal sepsis. Neonatal hypoglycemia was more common in the betamethasone group than in the placebo group (24.0% vs. 15.0%; relative risk, 1.60; 95% CI, 1.37 to 1.87; P

    Original languageEnglish (US)
    Pages (from-to)1311-1320
    Number of pages10
    JournalNew England Journal of Medicine
    Volume374
    Issue number14
    DOIs
    StatePublished - Apr 7 2016

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    Betamethasone
    Pregnancy
    Placebos
    Transient Tachypnea of the Newborn
    Confidence Intervals
    Oxygen
    Chorioamnionitis
    Bronchopulmonary Dysplasia
    Extracorporeal Membrane Oxygenation
    Continuous Positive Airway Pressure
    Stillbirth
    Artificial Respiration
    Hypoglycemia
    Surface-Active Agents
    Multicenter Studies
    Morbidity
    Injections
    Incidence

    ASJC Scopus subject areas

    • Medicine(all)

    Cite this

    Gyamfi-Bannerman, C., Thom, E. A., Blackwell, S. C., Tita, A. T. N., Reddy, U. M., Saade, G., ... Jain, L. (2016). Antenatal betamethasone for women at risk for late preterm delivery. New England Journal of Medicine, 374(14), 1311-1320. https://doi.org/10.1056/NEJMoa1516783

    Antenatal betamethasone for women at risk for late preterm delivery. / Gyamfi-Bannerman, C.; Thom, E. A.; Blackwell, S. C.; Tita, A. T N; Reddy, U. M.; Saade, George; Rouse, D. J.; McKenna, D. S.; Clark, E. A S; Thorp, J. M.; Chien, E. K.; Peaceman, A. M.; Gibbs, R. S.; Swamy, G. K.; Norton, M. E.; Casey, B. M.; Caritis, S. N.; Tolosa, J. E.; Sorokin, Y.; Van Dorsten, J. P.; Jain, L.

    In: New England Journal of Medicine, Vol. 374, No. 14, 07.04.2016, p. 1311-1320.

    Research output: Contribution to journalArticle

    Gyamfi-Bannerman, C, Thom, EA, Blackwell, SC, Tita, ATN, Reddy, UM, Saade, G, Rouse, DJ, McKenna, DS, Clark, EAS, Thorp, JM, Chien, EK, Peaceman, AM, Gibbs, RS, Swamy, GK, Norton, ME, Casey, BM, Caritis, SN, Tolosa, JE, Sorokin, Y, Van Dorsten, JP & Jain, L 2016, 'Antenatal betamethasone for women at risk for late preterm delivery', New England Journal of Medicine, vol. 374, no. 14, pp. 1311-1320. https://doi.org/10.1056/NEJMoa1516783
    Gyamfi-Bannerman C, Thom EA, Blackwell SC, Tita ATN, Reddy UM, Saade G et al. Antenatal betamethasone for women at risk for late preterm delivery. New England Journal of Medicine. 2016 Apr 7;374(14):1311-1320. https://doi.org/10.1056/NEJMoa1516783
    Gyamfi-Bannerman, C. ; Thom, E. A. ; Blackwell, S. C. ; Tita, A. T N ; Reddy, U. M. ; Saade, George ; Rouse, D. J. ; McKenna, D. S. ; Clark, E. A S ; Thorp, J. M. ; Chien, E. K. ; Peaceman, A. M. ; Gibbs, R. S. ; Swamy, G. K. ; Norton, M. E. ; Casey, B. M. ; Caritis, S. N. ; Tolosa, J. E. ; Sorokin, Y. ; Van Dorsten, J. P. ; Jain, L. / Antenatal betamethasone for women at risk for late preterm delivery. In: New England Journal of Medicine. 2016 ; Vol. 374, No. 14. pp. 1311-1320.
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    abstract = "BACKGROUND: Infants who are born at 34 to 36 weeks of gestation (late preterm) are at greater risk for adverse respiratory and other outcomes than those born at 37 weeks of gestation or later. It is not known whether betamethasone administered to women at risk for late preterm delivery decreases the risks of neonatal morbidities. METHODS: We conducted a multicenter, randomized trial involving women with a singleton pregnancy at 34 weeks 0 days to 36 weeks 5 days of gestation who were at high risk for delivery during the late preterm period (up to 36 weeks 6 days). The participants were assigned to receive two injections of betamethasone or matching placebo 24 hours apart. The primary outcome was a neonatal composite of treatment in the first 72 hours (the use of continuous positive airway pressure or high-flow nasal cannula for at least 2 hours, supplemental oxygen with a fraction of inspired oxygen of at least 0.30 for at least 4 hours, extracorporeal membrane oxygenation, or mechanical ventilation) or stillbirth or neonatal death within 72 hours after delivery. RESULTS: The primary outcome occurred in 165 of 1427 infants (11.6{\%}) in the betamethasone group and 202 of 1400 (14.4{\%}) in the placebo group (relative risk in the betamethasone group, 0.80; 95{\%} confidence interval [CI], 0.66 to 0.97; P = 0.02). Severe respiratory complications, transient tachypnea of the newborn, surfactant use, and bronchopulmonary dysplasia also occurred significantly less frequently in the betamethasone group. There were no significant between-group differences in the incidence of chorioamnionitis or neonatal sepsis. Neonatal hypoglycemia was more common in the betamethasone group than in the placebo group (24.0{\%} vs. 15.0{\%}; relative risk, 1.60; 95{\%} CI, 1.37 to 1.87; P",
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    T1 - Antenatal betamethasone for women at risk for late preterm delivery

    AU - Gyamfi-Bannerman, C.

    AU - Thom, E. A.

    AU - Blackwell, S. C.

    AU - Tita, A. T N

    AU - Reddy, U. M.

    AU - Saade, George

    AU - Rouse, D. J.

    AU - McKenna, D. S.

    AU - Clark, E. A S

    AU - Thorp, J. M.

    AU - Chien, E. K.

    AU - Peaceman, A. M.

    AU - Gibbs, R. S.

    AU - Swamy, G. K.

    AU - Norton, M. E.

    AU - Casey, B. M.

    AU - Caritis, S. N.

    AU - Tolosa, J. E.

    AU - Sorokin, Y.

    AU - Van Dorsten, J. P.

    AU - Jain, L.

    PY - 2016/4/7

    Y1 - 2016/4/7

    N2 - BACKGROUND: Infants who are born at 34 to 36 weeks of gestation (late preterm) are at greater risk for adverse respiratory and other outcomes than those born at 37 weeks of gestation or later. It is not known whether betamethasone administered to women at risk for late preterm delivery decreases the risks of neonatal morbidities. METHODS: We conducted a multicenter, randomized trial involving women with a singleton pregnancy at 34 weeks 0 days to 36 weeks 5 days of gestation who were at high risk for delivery during the late preterm period (up to 36 weeks 6 days). The participants were assigned to receive two injections of betamethasone or matching placebo 24 hours apart. The primary outcome was a neonatal composite of treatment in the first 72 hours (the use of continuous positive airway pressure or high-flow nasal cannula for at least 2 hours, supplemental oxygen with a fraction of inspired oxygen of at least 0.30 for at least 4 hours, extracorporeal membrane oxygenation, or mechanical ventilation) or stillbirth or neonatal death within 72 hours after delivery. RESULTS: The primary outcome occurred in 165 of 1427 infants (11.6%) in the betamethasone group and 202 of 1400 (14.4%) in the placebo group (relative risk in the betamethasone group, 0.80; 95% confidence interval [CI], 0.66 to 0.97; P = 0.02). Severe respiratory complications, transient tachypnea of the newborn, surfactant use, and bronchopulmonary dysplasia also occurred significantly less frequently in the betamethasone group. There were no significant between-group differences in the incidence of chorioamnionitis or neonatal sepsis. Neonatal hypoglycemia was more common in the betamethasone group than in the placebo group (24.0% vs. 15.0%; relative risk, 1.60; 95% CI, 1.37 to 1.87; P

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