Use of antenatal steroids during late preterm delivery prevents neonatal respiratory complications

Society for Maternal-Fetal MedicineFeb 2 2016

In a study to be presented on Feb. 4 in the oral plenary session at 8 a.m. EST, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting™, in Atlanta, researchers with the Eunice Kennedy Shriver National Institute of Child Health and Human Development and Maternal-Fetal Medicine Units Network (MFMU) found that the administration of antenatal steroids in pregnancies at risk for late preterm delivery prevents respiratory and other neonatal complications.

The study, titled Antenatal Late Preterm Steroids (ALPS): a Randomized Trial to Reduce Neonatal Respiratory Morbidity was a randomized, double-blind, placebo-controlled, trial at 17 tertiary medical centers around the United States from Oct. 2010 to Feb. 2015. The study enrolled 2,831 women with singleton pregnancies at high risk for late preterm delivery (34 0/7 to 36 6/7 weeks) who were randomized to receive antenatal betamethasone intramuscularly or a matching placebo. This study found a significant decrease in neonatal respiratory complications in the group given the steroid treatment. Investigators also found that these babies were less likely to have prolonged intensive care nursery stays, less likely to need post natal treatment for respiratory complications, and less likely to develop bronchopulmonary dysplasia, which is a sign of chronic lung disease.

Lead investigator, Cynthia Gyamfi-Bannerman, M.D., MSc, the Ellen Jacobson Levine and Eugene Jacobson Associate Professor of Women's Health (in Obstetrics and Gynecology) from Columbia University Medical Center, put the findings in context: "The majority of preterm deliveries occur in the late preterm period. We now have a treatment that can significantly improve outcomes for these at risk babies." The study was co-funded by the NHLBI, with the aid of program officer Carol Blaisdell, M.D. and the NICHD under the guidance of Uma Reddy, M.D.

Given that more than 300,000 pregnancies deliver in the late preterm period each year in the U.S., this study will have significant impact on health of the newborns and infants.