Department of Obstetrics and Gynecology, Cooper University Hospital, Camden, NJ, USA.
Am J Obstet Gynecol. 2012 Mar;206(3):201.e1-11. doi: 10.1016/j.ajog.2012.01.025.
We sought to determine whether the incidence of neonatal respiratory distress syndrome (RDS) is similar with 12- vs 24-hour dosing interval of betamethasone.
This was a prospective, randomized, open, noninferiority trial. Mothers (n = 228) with a singleton or multiple pregnancies (fetuses = 260), between gestational age of 23-34 weeks, at risk for preterm delivery, received standard 2 doses of betamethasone either 12 or 24 hours apart in 2:1 ratio, respectively.
Incidence of RDS was similar in the 2 cohorts (36.5% vs 37.3%; P = not significant). Women unable to receive the complete course of corticosteroids with the 24-hour interval can be reduced by half with the 12-hour interval. However, increased incidence of necrotizing enterocolitis was seen with 12-hour dosing (6.2% vs 0%; P = .03).
The 12-hour dosing interval is equivalent to the 24-hour dosing interval for prevention of RDS in neonates of mothers delivering prematurely. A larger multicenter study is needed to confirm our findings.
我们旨在确定倍他米松的 12 小时与 24 小时给药间隔对新生儿呼吸窘迫综合征（RDS）的发生率是否相似。
这是一项前瞻性、随机、开放、非劣效性试验。母亲（n=228）患有单胎或多胎妊娠（胎儿=260），妊娠 23-34 周，有早产风险，分别以 2:1 的比例接受标准的 2 剂倍他米松，间隔 12 或 24 小时。
两组的 RDS 发生率相似（36.5% vs 37.3%；P=无显著差异）。不能接受完整倍他米松疗程的妇女，采用 12 小时间隔可减少一半。然而，12 小时给药间隔会增加坏死性小肠结肠炎的发生率（6.2% vs 0%；P=0.03）。
对于早产儿母亲的新生儿 RDS 预防，12 小时给药间隔与 24 小时给药间隔等效。需要更大规模的多中心研究来证实我们的发现。
