Antenatal dexamethasone prior to term elective caesarean section and incidence of neonatal respiratory morbidity : a randomized trial

Abstract EN

Background: Elective caesarean section is a risk factor for the development of neonatal respira-tory complications, resulted in increased admission to neonatal special care units.

Aim : To assess the effect of prophylactic corticosteroids administration before elective CS at term in reducing neonatal respiratory morbidity and admission to neonatal special care units.

Subjects and Meth-ods : This randomized trial has been conducted among women subjected to term elective CS at Obstetrics and Gynecology Department of Suez Canal University Hospitals.

Women who were el-igible for the study (n = 226) were divided into two groups (study group and control group).

At 37 weeks gestation, they received two intramuscular doses of 12mg dexamethasone, while the control group given the usual care without steroids.

We examined adverse neonatal respiratory outcomes (Respiratory Distress Syndrome and Transient Tachypnea of the Newborn) and rates of neonatal care unit’s admissions in both groups.

Results: Neonates in the treatment group had a significantly lower overall incidence of respiratory distress morbidity 7.9 % versus 23% in non-treated group mainly with TTN (7 % versus 19.6% in non-treated group, p-value = 0.009*).

Mean-while ; according to the degree of respiratory distress there was significantly lower incidence of both mild and moderate degrees of respiratory distress in the treatment group (7 % and 0.9 %, re-spectively) to be (17 % and 5.3 % respectively) in the control group.

Conclusion: The effect of prophylactic corticosteroids administration before elective CS at term looks to be promising in reducing neonatal respiratory morbidity