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Cited by 2,544Neonatal Respiratory Health ResearchInfant Development and Preterm CarePreterm Birth and Chorioamnionitis

A CONTROLLED TRIAL OF ANTEPARTUM GLUCOCORTICOID TREATMENT FOR PREVENTION OF THE RESPIRATORY DISTRESS SYNDROME IN PREMATURE INFANTS

Liggins, G. C., Howie, R. N.·1972·Pediatrics
DOI 10.1542/peds.50.4.515
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Abstract

A controlled trial of betamethasone therapy was carried out in 282 mothers in whom premature delivery threatened or was planned before 37 weeks' gestation, in the hope of reducing the incidence of neonatal respiratory distress syndrome by accelerating functional maturation of the fetal lung. Two hundred and thirteen mothers were in spontaneous premature labor. When necessary, ethanol or salbutamol infusions were used to delay delivery while steroid or placebo therapy was given. Delay for at least 24 hours was achieved in 77% of the mothers. In these unplanned deliveries, early neonatal mortality was 3.2% in the treated group and 15.0% in the controls (p 0.01). There were no deaths with hyaline membrane disease or intraventricular cerebral hemorrhage in infants of mothers who had received betamethasone for at least 24 hours before delivery. The respiratory distress syndrome occurred less often in treated babies (9.0%) than in controls (25.8%, p 0.003), but the difference was confined to babies of under 32 weeks' gestation who had been treated for at least 24 hours before delivery (11.8% of the treated babies compared with 69.6% of the control babies p. 0.02). There may be an increased risk of fetal death in pregnancies complicated by severe hypertensionedema-proteinuria syndromes and treated with betamethasone, but no other hazard of steroid therapy was noted. We conclude that this preliminary evidence justifies further trials, but that further work is needed before any new routine procedure is established.

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  • The fitted global coupling coefficient indicates a substantial placental contribution to the maturation trajectory in this cohort.

    “The fitted global coupling coefficient (k = 0.58; Table 1) indicated a substantial placental contribution to the maturation trajectory in this cohort, consistent with physiologic evidence that placental insufficiency can delay surfactant synthesis (16, 17).”

    From Placenta-pulmonary coupling-guided multimodal AI for fetal lung maturity staging and individualized glucocorticoid therapy (2026) · cites this paper as [16]

  • Glucocorticoids are crucial during fetal development for the functional maturation of the respiratory system.

    “Glucocorticoids are crucial during fetal development for the functional maturation of the respiratory system [90,91,92] and are currently utilized as the standard of care for women at high risk for preterm delivery to prevent respiratory distress syndrome [93].”

    From Stress and the HPA Axis: Balancing Homeostasis and Fertility. (2017) · cites this paper as [91]

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Authors
Liggins, G. C., & Howie, R. N.
Affiliations
University of Auckland (NZ)
Venue
Pediatrics
Publisher
American Academy of Pediatrics (AAP)
Published
1972-10-01
Volume
50
Issue
4
Pages
515-525
ISSN
  • 0031-4005 (ISSN-L)
  • 1098-4275
DOI
10.1542/peds.50.4.515
OpenAlex
W1902039366
Cited by
2,544
References
0
Citations by year
2026: 42 · 2025: 62 · 2024: 53 · 2023: 75 · 2022: 86 · 2021: 70 · 2020: 63 · 2019: 80 · 2018: 61 · 2017: 84 · 2016: 81 · 2015: 56 · 2014: 61 · 2013: 61 · 2012: 82
FWCI
61.52
Type
journal article
Language
en
Open access
closed
Locations
  • PEDIATRICS (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
  • Health Sciences › Medicine › Epidemiology › Preterm Birth and Chorioamnionitis
Keywords
betamethasone, respiratory distress syndrome, hyaline membrane disease, preterm infants, preterm labor, fetal lung maturation, neonatal mortality, intraventricular hemorrhage, hypertension in pregnancy, gestational age
MeSH terms
Betamethasone, Clinical Trials as Topic, Cortisone, Female, Gestational Age, Glucocorticoids, Humans, Hyaline Membrane Disease, Infant, Newborn, Obstetric Labor, Premature, Lung, Male, Pregnancy, Pulmonary Surfactants, Respiratory Distress Syndrome, Newborn, Time Factors

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