Background: Neonatal Respiratory Distress Syndrome (NRDS) is one of the most frequent
causes of neonatal mortality especially in premature infants. Although it has been well established
that maternal antenatal corticosteroid therapy has a positive effect on NRDS reduction, yet
the effectiveness of this treatment in multifetal pregnancies is dubious.
Objective: We aimed to investigate the effect of betamethasone therapy on the incidence of NRDS
in multifetal pregnancies through a randomized controlled trial.
Methods: 140 women with a multifetal pregnancy at less than 28 weeks’ gestational age were randomly
allocated into intervention and control groups. Women at the intervention group received
intramuscularly betamethasone (12 mg/kg/BW twice). Neonatal outcomes were evaluated between
two groups of intervention and control, and two subgroups of preterm and term births. This study is
registered with the Iranian Clinical Trials Registry, number IRCT20180227038879N1.
Results: The incidence of NRDS was significantly lower in infants of betamethasone group than the
ones in the control group (4.9% vs 18.1%, P=0.034) while it did not show a significant reduction in
preterm infants compared to mature ones. Also, the intervention group presented a significant lower
neonatal ventilation than the control group (47.2% vs 63.2%, P=0.041). Other neonatal outcomes,
including age at birth, birth weight, Apgar score, NICU admission, and the number of mortalities
were not significantly different between study groups.
Conclusion: Betamethasone therapy during 28-32 weeks of gestation in multifetal pregnancies was
associated with better neonatal outcomes through significant reductions in NRDS incidence and
requiring ventilator treatment. However, betamethasone administration did not reduce the chance of
NRDS in premature infants.