Effect of antenatal corticosteroids in late preterm delivery on neonatal morbidity: A Randomised Controlled Trial

Objective: The use of antenatal corticosteroids beyond 34 weeks of gestation remains a debate. This study sought to determine the effect of use of antenatal corticosteroids in late preterm delivery on neonatal morbidity. Design: It was a randomized double-blind placebo and active controlled multi arm trial. There were two study groups and one control group. Setting: It was conducted at the department of Obstetrics and Gynaecology and the Department of Paediatrics of Ahmadu Bello University Teaching Hospital Zaria. Population: Pregnant women at 34 weeks 0 days to 36 weeks 6 days of gestation scheduled for elective/emergency delivery were recruited for the study. Methods: The study groups had dexamethasone and betamethasone respectively while the control group had a placebo. Main outcome: The primary outcome was incidence of respiratory distress syndrome. Results: A total of 138 mothers and 146 preterm neonates were included in the study with 48 exposed to placebo, 49 exposed to betamethasone and 49 exposed to dexamethasone. A pairwise analysis was done to test for difference between the groups. There was no statistically significant difference in the incidence of respiratory distress syndrome between the dexamethasone vs placebo (p= 0.98, RR 1, CI 0.06-16.89), betamethasone vs placebo (p= 0.98 RR 1, CI 0.09-11.55) and dexamethasone vs betamethasone (p=0.32, RR 0.5, CI 0.09-2.42) Conclusion: Antenatal corticosteroids may decrease the need for neonatal resuscitation at birth in late preterm neonates.