Publication:

Comparative study of dexamethasone and betamethasone for women at risk of preterm birth

Background Prematurity represents a serious problem for healthcare services throughout the world. Respiratory distress syndrome, neonatal death, intra-ventricular hemorrhage and low birth weight are continues to be the serious problems during the neonatal period, affecting a large number of premature infants. Dexamethasone and betamethasone are the two antenatal corticosteroids recommended for accelerating fetal lung development in threatened preterm birth.

Methods This is a prospective comparative study conducted in the Department of Obstetrics and Gynecology, at Hiram Hospital, a tertiary care center situated in the rural area of Vadodara, in which 100 pregnant women of gestational age between 24 and 34 weeks with risk of preterm birth were taken as candidates for antenatal treatment with corticosteroids. Ethical approval was taken from the institutional ethical committee. Informed consent was taken from the patients. A detailed history and examination was done. 100 pregnant women of gestational age between 24 and 34 weeks with risk of preterm birth were selected randomly and divided into 2 groups of 50 each. Group A was given injection of dexamethasone 6mg intramuscularly 12 hours apart. Group B was given injection of betamethasone 12mg intramuscularly 24hours apart. Patients were observed for neonatal death, respiratory distress syndrome, intra-ventricular hemorrhage and low birth weight.

Results In our study there was no significant difference between the two groups in rate of neonatal mortality (4% v/s 4%) and respiratory distress syndrome (38% v/s 40%). However, the rates of intra-ventricular hemorrhage (6% v/s 12%) and low birth weight (52% v/s 62%) were significantly low in neonates exposed to dexamethasone compared with betamethasone.

Conclusions Dexamethasone is recommended over betamethasone for its efficacy, safety, wide availability and low cost for treatment of women at risk of preterm delivery.