What are the benefits/risks of giving betamethasone to women at risk of late preterm labor?
EVIDENCE-BASED ANSWER:
Giving betamethasone to women at risk for delivery between 34 weeks 0 days and 36 weeks 6 days can lower by almost 40% the incidence of transient tachypnea of the newborn, severe respiratory distress syndrome, and the use of surfactant (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]).
Betamethasone may increase neonatal hypoglycemia, but the hypoglycemia isn’t associated with a prolonged hospital stay or other negative outcomes.
RECOMMENDATIONS
Both the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine have published recommendations supporting corticosteroids for threatened late preterm delivery with certain caveats.4-6 Because of a lack of evidence, maternity care providers shouldn’t give corticosteroids for threatened late preterm delivery to women with multiple gestation, diabetes, previous exposure to steroids during pregnancy, or pregnancies with major nonlethal fetal malformations.4-6 Evidence doesn’t support tocolysis when steroids are given in the late preterm period.4,5
