In Late Preterm Births, This Rx Could Help Baby's Lungs

Corticosteroid use in late preterm delivery tied to reduced lung problem risk in babies

(RxWiki News) Doctors have prescribed steroids to pregnant women at risk of preterm delivery for decades. But what about those at risk of late preterm delivery?

Not so much — but steroid prescriptions may help these women's babies stay healthier, a new study found.

In preterm delivery, or delivery before 34 weeks of pregnancy, one common fear is that a baby's lungs won't be sufficiently developed, which could be lethal. Doctors often prescribe corticosteroids to women at risk of preterm delivery because these drugs can accelerate an unborn baby's lung development.

But in women at risk of late preterm delivery, or delivery between 34 and 36 weeks, steroid prescriptions are much less common — likely because babies delivered at this stage have much higher survival rates than babies delivered earlier, according to a press release from Columbia University Medical Center (CUMC).

Still, late preterm babies have increased rates of respiratory problems compared to babies born at term (37 weeks or later), according to this study. That's where a steroid prescription for pregnant women at risk of late preterm delivery could step in.

"Our study demonstrates that administering a medication that is commonly used to prevent complications in babies born before 34 weeks of gestation can also reduce the risk of many serious complications in babies delivered just a few weeks before term," said lead study author Cynthia Gyamfi-Bannerman, MD, an associate professor of women's health at CUMC, in a press release. "This will transform the way we care for mothers at risk for late preterm delivery."

To conduct this study, Dr. Gyamfi-Bannerman and team randomized more than 2,800 women at risk of late preterm delivery to receive either the steroid betamethasone (brand name Celestone Soluspan) or a placebo (fake treatment).

The babies of the women who received injections of betamethasone were less likely than those whose mothers got the placebo to have breathing or lung problems within a short time frame after birth, Dr. Gyamfi-Bannerman and team found. The babies whose mothers received betamethasone were also less likely to require neonatal intensive care.

"While survival among late preterm infants is comparable to that of babies born at term, the rate of respiratory problems and other serious complications in this group is not comparable and remains unacceptably high," Dr. Gyamfi-Bannerman said. "Expanding the use of a well-studied, safe medication to improve lung development before birth offers a means of preventing many of these complications."

These researchers are conducting further research to determine whether prenatal steroids might reduce long-term health effects in babies born during the late preterm period.

This study was published Feb. 4 in The New England Journal of Medicine.

The National Heart, Lung and Blood Institute and National Center for Advancing Translational Sciences funded this research. The authors disclosed no conflicts of interest.

Review Date: 
February 3, 2016