Betamethasone dosing interval at 12 or 24 h apart: A systematic review and meta-analysis
Abstract
OBJECTIVE
To compare the effectiveness of administering 24 mg of betamethasone in two doses (12 mg each) at 12-hour versus 24-hour intervals in patients at risk of preterm delivery.
DATA SOURCES
A search was conducted in Ovid, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, CINAHL, Scopus, and Google Scholar up to February 22, 2023. Search terms included "Betamethasone," "Preterm delivery," "Respiratory distress," "Dosing interval," and related keywords. No language or geographic restrictions were applied.
STUDY ELIGIBILITY CRITERIA
Randomized controlled trials of pregnant women at risk for preterm delivery between 23 and 34 weeks of gestation, randomized to receive 24 mg of betamethasone in two doses, either 12 or 24 h apart.
STUDY APPRAISAL AND SYNTHESIS METHODS
The primary outcome was the incidence of respiratory distress syndrome, with secondary outcomes including adverse maternal and neonatal events. Summary measures were reported as relative risk with 95% confidence intervals.
RESULTS
Two randomized controlled trials (429 patients) were included. The rate of RDS was lower in the 12-hour dosing group (34.3 % vs. 45.7 %; RR 0.76, 95 % CI 0.46-1.25), but the difference was not statistically significant. Significant reductions in NICU admissions, surfactant use, and an increase in birthweight were observed in the 12-hour group. No significant differences were found for perinatal mortality, neonatal sepsis, necrotizing enterocolitis,…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 429 participants or records.
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