Low Dose Antenatal Corticosteroids for Late Preterm Delivery
Low Dose Antenatal Corticosteroids for Late Preterm Delivery (LoDAC Study)
Rambam Health Care Campus
1,510 participants
Jan 1, 2022
INTERVENTIONAL
Conditions
Summary
This is a study proposal for a clinical trial to evaluate the effectiveness of a reduced dose of antenatal betamethasone (a steroid medication) in preventing respiratory problems in late preterm infants (born between 34 and 36 weeks of gestation). The study will be conducted in medical centers in Israel and will involve women who are at high risk for delivering a late preterm infant. The participants will be randomly assigned to receive either a full dose (12 mg) or a quarter dose (3 mg) of betamethasone, administered 24 hours apart. The main outcome measure of the study will be the incidence of respiratory problems or neonatal death within 72 hours of delivery in the two groups. The study is designed to determine if the reduced dose of betamethasone is non-inferior (i.e., not significantly worse) than the full dose in preventing respiratory problems in late preterm infants.
Eligibility
Inclusion Criteria5
- Criteria for determination of late preterm delivery risk:
- Preterm uterine contractions with intact membranes, and at least 3 cm dilation or 75% cervical effacement
- Spontaneous rupture of the membranes
- Expected preterm delivery for any other indication via induction or cesarean between 24 hours to 7 days after the planned randomization, as determined by the obstetric provider.
- \-
Exclusion Criteria5
- Expected delivery in less than 12 hours, irrespective of cause including: 1)ruptured membranes in the presence of more than 6 contractions per hour or cervical dilation of 3 centimeters or more unless oxytocin was withheld for at least 12 hours (although other induction agents were allowed), 2) chorioamnionitis, 3) cervical dilation of 8 cm or more, and 4) evidence of non-reassuring fetal status requiring immediate delivery.
- Prior ACS treatment
- Current known or suspected infection ( viral, bacterial or other)
- Pre-gestational diabetes mellitus.
- Any infection that required antibiotics or hospitalization in the month prior to study allocation - Poor understanding of the inform consent language
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Interventions
the two different group will differ in the doses of corticosteroids
Locations(16)
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NCT05698966