Poster Session 3
Frank I. Jackson, DO (he/him/his)
Maternal Fetal Medicine Fellow
Northwell
New Hyde Park, New York, United States
Sarah H. Abelman, MD (she/her/hers)
Maternal Fetal Medicine Fellow
Northwell
New Hyde Park, New York, United States
Nathan A. Keller, MD
Maternal Fetal Medicine Fellow
Northwell
Bay Shore, NY, United States
Luis A. Bracero, MD
Maternal Fetal Medicine Physician
Northwell
New Hyde Park, New York, United States
Annemarie Stroustrup, MD, MPH
Northwell
New Hyde Park, New York, United States
Matthew J. Blitz, MD
Director of Clinical Research, Maternal-Fetal Medicine, Northwell; Program Director, Maternal Fetal Medicine Fellowship, South Shore University Hospital
Northwell
Bay Shore, NY, United States
For patients expected to deliver before 34 weeks, betamethasone is usually given in two doses, 24 hours apart, to promote fetal lung maturity. If delivery is anticipated in less than 24 hours, some providers use an accelerated dosing regimen, but evidence for this practice is limited. Our objective was to determine the rate of severe neonatal morbidity (SNM) among early preterm deliveries (< 34 weeks) that occurred < 24 hours after the first dose of betamethasone was administered, and to compare the group that received one dose (standard) versus two doses (accelerated).
Study Design:
This is a retrospective cohort study of singleton preterm deliveries from 2019-2023 at two tertiary hospitals in New York. Patients were included if they delivered at less than 34-0/7 weeks of gestation, received at least one dose of betamethasone prior to delivery, and delivered less than 24 hours after the first dose of betamethasone was administered. The primary outcome was SNM, a composite neonatal adverse outcome indicator which includes diagnoses and procedures indicative of severe morbidity. A logistic regression model was used to compare the rates of SNM among individuals who received one (standard) or two doses (accelerated) of betamethasone within the 24 hours prior to delivery, controlling for gestational age at birth, as well as race and ethnicity group.
Results:
A total of 79 patients were included for analysis: 45 (56%) received standard betamethasone dosing and 34 (43%) received an accelerated dosing regimen. On adjusted analysis, there was no difference in composite SNM between the two groups (OR 1.16, 0.39-3.42, P=0.79). There was also no difference in rates of neonatal respiratory distress syndrome (OR 2.78, 0.81-10.35, P=0.11).
Conclusion:
For infants born before 34 weeks who delivered within 24 hours of a first betamethasone dose, there was no difference in SNM between those who received an accelerated second dose and those who did not.
