Photo Credit: thomasd007
The following is a summary of “Betamethasone Exposure and Neonatal Respiratory Morbidity Among Late Preterm Births by Planned Mode of Delivery and Gestational Age,” published in the December 2024 issue of Obstetrics and Gynecology by Clapp et al.
Late preterm antenatal steroids are used to reduce neonatal respiratory morbidity. The effects of these steroids may vary depending on the planned delivery mode and gestational age.
Researchers conducted a retrospective study to assess how late preterm antenatal steroids affect respiratory morbidity risk based on gestational age and planned delivery mode.
They analyzed data from the Antenatal Late Preterm Steroid (ALPS) Trial, involving 2,825 pregnant individuals at high risk for late preterm birth (34–36 weeks of gestation). Binomial regression models were used to estimate the risk of respiratory morbidity with and without steroids based on gestational age and planned delivery mode, assuming a homogeneous effect of steroids (adjusted risk ratio [RR] 1.90, 95% CI, 1.55–2.33 for cesarean delivery vs. vaginal delivery; adjusted RR 0.56, 95% CI, 0.50–0.63 by week of gestation).
The results showed that the risk of respiratory morbidity significantly varied by planned delivery mode and gestational age. For those planning cesarean delivery at 34 weeks of gestation, the risk was 39.4% (95% CI, 30.8–47.9%) without steroids and 32.0% (95% CI, 24.6–39.4%) with steroids. For those planning vaginal delivery at 36 weeks of gestation, the risk was 6.9% (95% CI, 5.2–8.6%) without steroids and 5.6% (95% CI, 4.2–7.0%) with steroids.
They concluded that the effect of late preterm antenatal steroids on respiratory morbidity risk varied significantly based on gestational age and delivery mode.
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