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 ≤5 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 β3-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 β-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.
Nasal Intermittent Positive Pressure Ventilation for Neonatal Respiratory Distress Syndrome
