Betamethasone and dexamethasone cause an
immature fetus's lungs to produce a compound called surfactant. A full-term
baby's lungs naturally produce surfactant, which lubricates the lining of the
air sacs within the lungs. This allows the inner surfaces of the air sacs to
slide against one another without sticking during breathing. Premature infants
whose lungs have begun producing surfactant are more able to breathe
on their own, or with less respiratory treatment, after birth.
delivery does not occur within 7 days of treatment, the injections should not
Betamethasone and dexamethasone are
corticosteroids, also called glucocorticoids, that are given before birth
(antenatally) to speed up a preterm fetus's lung development. Either is used
when a mother is in preterm labor and birth may occur in 24 to 48 hours. This
respiratory distress syndrome (RDS) and related
complications following premature birth.
Many infants born at 33
to 34 weeks' gestation have sufficient lung maturity to breathe on their own.
But considering the low-risk, high-benefit nature of this treatment,
corticosteroids are typically used up to 34 weeks of pregnancy.
There is strong evidence that a
single course of corticosteroid medicine given to the mother during premature
labor improves the outcome for the infant born between 24 and 34 weeks'
dexamethasone is most effective if delivery occurs at least 24 hours after the
first dose of the medicine has been given and less than 7 days after the last
dose of the medicine.
Either medicine will benefit a premature
newborn by lowering the risk of:
Corticosteroid side effects that might
affect the mother can include fluid retention and increased blood pressure. But
these are short-term side effects and less likely to occur at all during such a
short period of treatment. These side effects are more of a concern during
long-term treatment for other health problems.
diabetes may be more difficult in pregnant women when
corticosteroids are used. Your doctor may recommend a different insulin dose
during this time.
See Drug Reference for a full list of side
effects. (Drug Reference is not available in all systems.)
Fetal lung maturity testing
amniotic fluid collected through
amniocentesis) is sometimes used to determine whether
antenatal corticosteroid treatment is necessary.
of corticosteroids given before birth are not recommended.2 They may cause long-term effects on the growing
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
CitationsHaas DM (2010). Preterm birth, search date June 2009.
Online version of BMJ Clinical Evidence:
http://www.clinicalevidence.com.American Academy of Pediatrics and American College of
Obstetricians and Gynecologists (2007). Obstetric and medical complications. In
Guidelines for Perinatal Care, 6th ed., pp. 175–204. Elk
Grove Village, IL: American Academy of Pediatrics.French NP, et al. (2004). Repeated antenatal
corticosteroids: Effects on cerebral palsy and childhood behavior.
American Journal of Obstetrics and Gynecology, 190(3):
January 10, 2011
Sarah Marshall, MD - Family Medicine & William Gilbert, MD - Maternal and Fetal Medicine
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