Antenatal Betamethasone Compared With Dexamethasone (Betacode Trial)
| Autor: | David Garry, Reinaldo Figueroa, Alan R. Spitzer, J. Gerald Quirk, Vandy Wiencek, Andrew Elimian |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty medicine.drug_class Betamethasone Dexamethasone law.invention Double-Blind Method Randomized controlled trial Pregnancy law Humans Medicine Preterm delivery Cerebral Hemorrhage Respiratory Distress Syndrome Newborn business.industry Infant Newborn Obstetrics and Gynecology medicine.disease Clinical trial Fetal Diseases Tocolytic Agents Anesthesia Premature Birth Corticosteroid Female Morbidity Complication business medicine.drug |
| Zdroj: | Obstetrics & Gynecology. 110:26-30 |
| ISSN: | 0029-7844 |
| DOI: | 10.1097/01.aog.0000268281.36788.81 |
| Popis: | To compare betamethasone with dexamethasone in terms of effectiveness in reducing perinatal morbidities and mortality among preterm infants.We enrolled 299 women at risk for preterm delivery in a double-blind, placebo-controlled, randomized trial of antenatal betamethasone compared with dexamethasone at Stony Brook University Hospital from August 2002 through July 2004. We excluded women with clinical chorioamnionitis, fetal structural and chromosomal abnormalities, prior antenatal steroid exposure, and steroid use for other indications. Statistical analysis was performed in accordance of the intention-to-treat principle.There were no significant differences between the groups with regard to baseline characteristics. The rate of respiratory distress syndrome, need for vasopressor therapy, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, neonatal sepsis, and neonatal mortality were not significant different between the groups. However, the rates of intraventricular hemorrhage (6 of 105 [5.7%] compared with 17 of 100 [17.0%], relative risk [RR] 2.97, 95% confidence interval [CI] 1.22-7.24, P=.02) and any brain lesion (7 of 105 [6.7%] compared with 18 of 100 [18.0%], RR 2.7, 95% CI 1.18-6.19, P=.02) were significantly lower in neonates exposed to dexamethasone compared with betamethasone. The absolute risk reduction in the rate of intraventricular hemorrhage was 11.3 % ( 95% CI 2.7-11.9%), and the number needed to treat was 9 (95% CI 5-37) in favor of dexamethasone.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. |
| Databáze: | OpenAIRE |
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