Vol.:(0123456789) 1 3 Arch Gynecol Obstet (2018) 297:101–107 https://doi.org/10.1007/s00404-017-4557-8 MATERNAL-FETAL MEDICINE Does antenatal steroids treatment prior to elective cesarean section at 34–37 weeks of gestation reduce neonatal morbidity? Evidence from a case control study Michal Kirshenbaum 1  · Shali Mazaki‑Tovi 1,2  · Uri Amikam 1  · Ram Mazkereth 2,3  · Eyal Sivan 1,2  · Eyal Schif 1,2  · Yoav Yinon 1,2   Received: 3 June 2017 / Accepted: 28 September 2017 / Published online: 24 October 2017 © Springer-Verlag GmbH Germany 2017 Conclusion Antenatal treatment with corticosteroids prior to ECS at 34–37 weeks of gestation did not result in sig- nifcant reduction in neonatal respiratory morbidity in our cohort of patients. Keywords Antenatal corticosteroids · Elective cesarean section · Neonatal morbidity · Late prematurity Introduction Late preterm births account for 75% of all preterm births. The proportion of late preterm infants has dramatically increased during the last two decades, mostly due to increase in obstetric interventions following maternal or fetal compli- cations [1]. Infants born at 34–37 weeks of gestation are at higher risk for neonatal morbidity, particularly respiratory morbidity, as well as greater risk of being admitted to inten- sive care, compared with term infants. The rate of respira- tory complication including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), oxygen requirement and ventilator support is approximately 10%, with an obvious higher risk among the earlier gestational age of this range [2–5]. In order to improve the neonatal outcome of late preterm infants, antenatal treatment with corticos- teroids to excel fetal lung maturation has been suggested. The benefcial efects of corticosteroids before 34 weeks of pregnancy have been well established [6, 7]. However, the results regarding the efcacy of corticosteroids beyond 34 weeks of gestation have been conficting [8, 9]. Moreover, the American College of Obstetricians and Gynecologists has recommended that corticosteroids should be adminis- tered to pregnant women who are at risk for preterm delivery only before 34 weeks of gestation [10]. Abstract Objective To determine whether antenatal corticosteroids administration prior to an elective cesarean section (ECS) at 34–37 weeks gestation is associated with improved neonatal outcome. Materials and methods A case control study of women with singleton pregnancies who underwent ECS between 34 and 37 weeks of gestation including two groups: (1) study group in which patients were treated with betamethasone prior to ECS (n = 58) and (2) control group matched for gestational age at delivery in which patients did not receive betamethasone (n = 107). Neonatal measures including respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), oxygen requirement, admission to the special care unit, hypoglycemia, hyperbilirubinemia and length of hospitalization were determined in both groups. Composite respiratory morbidity was defned as the pres- ence of either RDS, TTN, mechanical ventilation or oxygen requirement. Results There was no signifcant diference in the rate of composite respiratory morbidity nor its components between patients with and without betamethasone treatment (25.9 vs. 25.2%, respectively, p = 0.9). * Michal Kirshenbaum michal.siegel@gmail.com 1 Department of Obstetrics and Gynecology, Sheba Medical Center, 52621 Tel-Hashomer, Israel 2 Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel 3 Department of Neonataology, Edmond and Lily Safra Children Hospital, Sheba Medical Center, Tel-Hashomer, Israel