Neonatal respiratory distress syndrome after repeat exposure to antenatal corticosteroids: a randomised controlled trial

Preterm infants are at high risk of respiratory distress syndrome (RDS) as a consequence of immature lung development. RDS is the principle cause of early mortality and contributes significantly to the high costs of neonatal care. Prenatal corticosteroids substantially reduce the risk of RDS in babies born within 7 days of maternal treatment. Hence, in clinical practice, there has been a tendency to repeat the dose after 7 days in women who remain at risk of preterm birth. However, no formal policy exists. This trial seeks to evaluate the beneficial and adverse effects of repeat doses of prenatal steroids as they may provide a simple, inexpensive way to improve health outcomes for preterm infants. Multi-centre, placebo controlled, double-blind trial. All participants, caregivers, researchers and data analyst are blinded until all prespecified analyses completed. The corticosteroid and saline placebo syringes were identically labelled and the contents masked.