Single versus weekly courses of antenatal corticosteroids in preterm premature rupture of membranes.

Men Jean Lee, Jill Davies, Debra Guinn, Lisa Sullivan, M. Wendy Atkinson, Scott McGregor, Barbara V. Parilla, Kathleen Hanlon-Lundberg, Lynn Simpson, Joanne Stone, Deborah Wing, Keith Ogasawara, Jonathon Muraskas

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

OBJECTIVE: This study was performed to evaluate the efficacy of weekly courses of antenatal corticosteroids compared with a single course in women with preterm premature rupture of membranes (PROM). METHODS: A planned secondary analysis of women with preterm PROM who participated in a multicenter, randomized trial of weekly courses of antenatal corticosteroids versus single-course therapy was performed. After their first course of standard antenatal steroid therapy, administered between 24 to 32-6/7 weeks of gestation, consenting women were randomly assigned to receive betamethasone versus placebo injections weekly until 34-0/7 weeks of gestation. Maternal and neonatal morbidities were compared between the 2 groups. RESULTS: Of the 161 women with preterm PROM, 81 women were assigned to receive weekly courses of steroids and 80 to the single-course group. There were no significant differences in composite morbidity between the groups (27 [34.2%] of 81 patients versus 33 [41.8%] of 80 patients, P =.41). Chorioamnionitis was higher in patients who received weekly courses of antenatal steroids (39 [49.4%] of 81 patients versus 25 [31.7%] of 80 patients, P =.04). CONCLUSION: Weekly courses of antenatal steroids in women with preterm PROM did not improve neonatal outcomes beyond that achieved with single-course therapy and was associated with an increased risk of chorioamnionitis. Antenatal steroid therapy should not be routinely repeated in patients with preterm PROM. LEVEL OF EVIDENCE: I

Original languageEnglish (US)
Pages (from-to)274-281
Number of pages8
JournalObstetrics and gynecology
Volume103
Issue number2
DOIs
StatePublished - Feb 2004
Externally publishedYes

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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