PEDIATRICS Vol. 83 No. 4 April 1989, pp. 493-497
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Reduction of Mortality, Morbidity, and Respiratory Distress Syndrome in Infants Weighing Less than 1,000 Grams by Treatment With Betamethasone and Ritodrine

Apostolos N. Papageorgiou MD, FRCPC1, Jean-Luc Doray MD, FRCPC1, Rosendo Ardila MD1, and IIdiko Kunos MD, FRCPC1

1 McGill University, Sir Mortimer B. Davis Jewish General Hospital Perinatal Center, Montreal

The efficacy of betamethasone has been questioned in infants of less than 28 week's gestation. From January 1983 to June 1986, 86 infants weighing 600 to 1,000 g were born at our center. Control of labor was attempted with ritodrine in all patients with le5 cm cervical dilation. If control were obtained, betamethasone was given 30 minutes later. Significant differences were found between the 33 infants born after 24 hours of betamethasone and those delivered before in terms of survival 90.1% v 56.6% (P = .001), respiratory distress syndrome 27.2% v 73.6% (P = .0001), and need for intermittent positive pressure ventilation 42.4% v 81.1% (P = .0005). The average hospital stay for beta3-treated infants was 82 days v 99 days for nontreated infants. The average exposure to O2 after betamethasone was 12.7 days v 20.2 days, (P = .01), although need for intermittent positive pressure ventilation was similar (23 days) in the two groups. In infants who survived > 48 hours, the incidence of patent ductus arteriosus in the beta-group was 18.8% (6/32) v 44.4% (16/36) in the nontreated group (P = .04). Our data suggest that in infants weighing less than 1,000 g, control of labor with ritodrine for a minimum of 24 hours and administration of betamethasone can reduce significantly not only the incidence of respiratory distress syndrome but also mortality and morbidity.

Key Words: betamethasone • ritodrine • very low birth weight • respiratory distress syndrome • mortality • morbidity

Submitted on March 3, 1988
Accepted on June 8, 1988




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