The first 48 hours: Comparing 12-hour and 24-hour betamethasone dosing when preterm deliveries occur rapidly

Objective. To compare neonatal outcomes when dosing betamethasone every 12 hours compared to the standard 24-hour dosing regimen when premature deliveries occur within 48 hours of presentation. Methods. A retrospective chart review was performed on preterm deliveries from January 1, 1996 to July 1, 2000. Deliveries that occurred less than 48 hours after initiation of antenatal steroids were analyzed for neonatal outcomes. Results. Betamethasone was given to 562 women, of whom 166 delivered less than 48 hours after beginning therapy. There were no statistically significant differences in the rates of respiratory distress syndrome, surfactant use, chronic lung disease, intraventricular hemorrhage, neonatal death, or other outcomes between the two groups. The only statistically significant difference between the two groups was for venous cord blood pH (7.27 vs. 7.32, p = 0.01). Separating the results into delivery from 0-24 and 24-48 hour groups, there were no significant differences between the 12-hour and 24-hour dosing groups, although small sample size limited conclusions. Conclusion. Dosing betamethasone in 12-hour intervals may result in similar neonatal outcomes compared to the standard 24-hour regimen when delivery occurs within 48 hours of therapy initiation.