A randomized, controlled trial of oral and intramuscular dexamethasone in the prevention of neonatal respiratory distress syndrome☆,☆☆,★
Section snippets
Material and methods
After institutional review board approval and informed consent were obtained, subjects at high risk for preterm delivery were recruited between 24 and 33 weeks’ gestation. Patients were randomly assigned (by computer-generated numbers placed in sealed envelopes) to receive dexamethasone either as 6 mg intramuscularly or as 8 mg orally every 12 hours for 4 doses. Patient compliance was monitored by nursing personnel. Complete corticosteroid courses were repeated at 7 days after the last
Results
One hundred seventy women were recruited between July 1996 and July 1997. Five patients were unavailable for follow-up, leaving 165 subjects for analysis. Ninety-two women received oral dexamethasone and 78 women received intramuscular dexamethasone. Five women in the intramuscular group and 7 women in the oral group had received 1 dose of betamethasone at their community hospital before transport.
Maternal age, race, gestational age at random assignment, cervical dilation, and prevalence of
Comment
In this study women at risk for preterm delivery were randomly assigned to receive either 8 mg oral or 6 mg intramuscular dexamethasone every 6 hours for 4 doses. The regimen was repeated until 34 weeks’ gestation was reached. Although we found no statistical difference in the primary outcome of respiratory distress syndrome, higher frequencies of intraventricular hemorrhage and neonatal sepsis were seen in the group treated with oral dexamethasone, an unexpected finding. Gestational age at
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Cited by (0)
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From the Department of Obstetrics and Gynecology, University of Tennessee, Memphis.
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Reprint requests: Robert S. Egerman, MD, Department of Obstetrics and Gynecology, University of Tennessee, Memphis, 853 Jefferson, Suite E 102, Memphis, TN 38103.
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0002-9378/98 $5.00 + 0 6/6/93262