The Effect of Plurality and Obesity on Betamethasone Concentrations in Women at Risk for Preterm Delivery

Overview

Journal Am J Obstet Gynecol

Publisher Elsevier

Specialty Gynecology & Obstetrics

Date 2010 Jun 29

PMID 20579955

Citations 12

Authors

Cynthia Gyamfi

Lisa Mele

Ronald J Wapner

Catherine Y Spong

Alan Peaceman

Yoram Sorokin

Donald J Dudley

Francee Johnson

Kenneth J Leveno

Steve N Caritis

Brian M Mercer

John M Thorp Jr

Mary J OSullivan

Susan M Ramin

Marshall Carpenter

Dwight J Rouse

Menachem Miodovnik

Baha Sibai

Affiliations

Soon will be listed here.

Abstract

Objective: Antenatal corticosteroids (ACS) decrease respiratory distress syndrome in singleton gestations. Twin data are less clear. Obesity and body mass index (BMI) also affect medication distribution volume. We evaluated whether maternal or neonatal cord betamethasone concentrations differed in twin gestations or obese patients.

Study Design: Participants receiving betamethasone in a randomized controlled trial of weekly ACS were identified. We analyzed maternal delivery and cord serum betamethasone concentrations comparing singletons with twins and obese (BMI > or =30 kg/m(2)) with nonobese women.

Results: Fifty-five maternal and 45 cord blood samples were available. Unadjusted median maternal serum concentrations appeared paradoxically higher in both twin gestations and the obese. However, after controlling for confounders, there were no differences in betamethasone concentrations in maternal serum or cord blood between singletons and twins (P = .61 vs P = .14) or nonobese and obese women (P = .67 vs .12).

Conclusion: Maternal and umbilical cord blood serum betamethasone concentrations are not different in twin gestations or obese women.

Citing Articles

Effects of antenatal corticosteroids on fetal hemodynamics: a longitudinal study.

Carelli M, Peixoto-Filho F, Velarde L, de Sa R, Monteiro V, Araujo Junior E Radiol Bras. 2024; 57:e20230129.

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Association between betamethasone levels and respiratory distress syndrome in preterm births: A prospective cohort study.

Zafran N, Massalha M, Suleiman A, Massalha R, Mahagna L, Weiner S Clin Transl Sci. 2022; 15(10):2528-2537.

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Benefits of a Single Dose of Betamethasone in Imminent Preterm Labour.

Saldana-Garcia N, Espinosa-Fernandez M, Gomez-Robles C, Postigo-Jimenez A, Bello N, Rius-Diaz F J Clin Med. 2022; 11(1).

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Estimating fetal exposure to the P-gp substrates, corticosteroids, by PBPK modeling to inform prevention of neonatal respiratory distress syndrome.

Anoshchenko O, Milad M, Unadkat J CPT Pharmacometrics Syst Pharmacol. 2021; 10(9):1057-1070.

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Do maternal demographics and prenatal history impact the efficacy of betamethasone therapy for threatened preterm labor?.

Kinney M, Quinney S, Trussell H, Silva L, Ibrahim S, Haas D BMC Pregnancy Childbirth. 2021; 21(1):442.

PMID: 34167497 PMC: 8228510. DOI: 10.1186/s12884-021-03949-5.

References

Liang K, Zeger S . Regression analysis for correlated data. Annu Rev Public Health. 1993; 14:43-68. DOI: 10.1146/annurev.pu.14.050193.000355. View

. Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consensus Development Panel on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. JAMA. 1995; 273(5):413-8. DOI: 10.1001/jama.1995.03520290065031. View

Liggins G, Howie R . A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972; 50(4):515-25. View

. ACOG Committee Opinion No. 402: Antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2008; 111(3):805-7. DOI: 10.1097/AOG.0b013e318169f722. View

Hamilton B, Martin J, Ventura S . Births: preliminary data for 2009. Natl Vital Stat Rep. 2014; 59(3):1-19. View