Prophylactic Antenatal Corticosteroid before Elective Cesarean Delivery at or Near Term to Improve Perinatal Outcome

Objective: To evaluate whether giving the recommended prophylactic course of dexamethasone before delivery reduces the occurrence of neonatal respiratory morbidities after elective cesarean delivery between 34 and 37 weeks. Methods: This randomized clinical trial recruited 130 women with singleton pregnancies between 34 and 37 weeks scheduled for elective cesarean delivery. They were randomized into 2 equal groups to receive either IM dexamethasone in 4 doses of 6mg/12 hours or nothing prior to delivery. Primary outcome was admission to neonatal intensive care unit (NICU) for respiratory morbidity. Results: Seven women were excluded from the study. There was no significant difference between the intervention and control groups regarding admission to NICU (p=0.535), respiratory distress syndrome (p=0.699), transient tachypnea of the neonate (p=0.612), need for mechanical ventilation (p=0.509), development of respiratory (p=0.612) or non-respiratory complications, readmission for respiratory problems (p=0.310). No neonatal deaths were recorded. Conclusion: Prophylactic antenatal corticosteroid for elective cesarean delivery between 34 and 37 weeksis not effective in improving neonatal outcomes.