Steroids before elective C-section at term studied.(Obstetrics)

A single course of betamethasone before an elective cesarean section at term may decrease the risk of developing neonatal respiratory distress or transient tachypnea, according to the results of a randomized, controlled trial.

The 10-center trial is the first of its kind to test the use of prenatal corticosteroids in women who were delivered by elective cesarean section at term (BMJ, doi:10.1136/bmj.38547.416493.06[2005]).

Infants whose mothers received betamethasone had a significantly lower rate of admission to the special care baby unit (11 of 467) than control infants (24 of 475). Betamethasone treatment reduced the incidence of admission to a special care baby unit by 54%, reported Peter Stutchfield, M.D., of Glan Clwyd Hospital (Wales) and his colleagues.

Still, Alex Vidaeff, M.D., of the University of Texas, Houston, questioned the significance of the study. "I don't see any clinical utility for U.S. practitioners because of a lack of external validity," he said in an interview.

Dr. Vidaeff, who has particular interest in research on corticosteroids and fetal maturation, as well as expertise working with H-441 adenocarcinoma lung cells, said interpretation of the study results is difficult without more information on the selection of patients for the study. He also noted that the risk-benefit ratio at more than 34 weeks' gestation is not favorable because the risk level already is low in this group.

In the study, during the 48 hours before elective cesarean section, the women received either two intramuscular doses of 12 mg of betamethasone separated by 24 hours or treatment as usual without corticosteroids.

The severity and type of respiratory distress (transient tachypnea in 10 ...