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Phase 4 Completed N=437 Randomized Quadruple-blind Prevention

A Randomized Trial Comparing the Impact of One Versus Two Courses of Antenatal Steroids (ACS) on Neonatal Outcome

Source: ClinicalTrials.gov NCT00201643 ↗
Enrolled (actual)
437
Serious AEs
8.0%
Results posted
Mar 2011
Primary outcomePrimary: Composite Neonatal Morbidity < 34 Weeks Gestation at Time of Birth. — 71; 105 participants — p=0.002

Summary

The hypothesis is that administration of two courses of antenatal corticosteroids, compared to one course, will show a 40% reduction in the incidence of composite neonatal morbidity in patients delivering prior to 34 weeks' gestation.

Outcome Measures

OutcomeResultp-value
PRIMARY
Composite Neonatal Morbidity < 34 Weeks Gestation at Time of Birth.
71; 105 0.002 sig
SECONDARY
Gestational Age at (@) Delivery
33.1; 33.0
SECONDARY
Neonatal Birth Weight Reported in Grams
1905; 1920
SECONDARY
Interuterine Growth Restriction (IUGR) or Small for Gestational Age(SGA)in Babies Delivering at < 34 Weeks Gestation.
25; 20
SECONDARY
Neonatal Head Circumference Taken at Time of Birth.
30.2; 30.0
SECONDARY
Number of Babies Who Required Ventilatory Support Within the First 28 Days of Life.
70; 95
SECONDARY
Number of Neonates Who Required Surfactant Therapy After Birth.
70; 99
SECONDARY
Number of Neonates With Pneumothorax
4; 4
SECONDARY
Maternal Infectious Morbidity.
8; 10

Eligibility Criteria

Inclusion Criteria

  • 25 to 32 6/7 weeks gestation
  • Singleton or twin gestation
  • Received 1st course of betamethasone prior to 30 weeks' gestation
  • Began 1st course of betamethasone at least 14 days prior to randomization
  • Risk of delivery in next 7 days due to either maternal or fetal complication (e.g. preterm labor, severe preeclampsia, IUGR, etc.)
  • Intact membranes

Exclusion Criteria

  • Known major fetal anomalies (eg: anencephaly, renal agenesis etc…)
  • High order multiple gestation (triplets or higher)
  • Cervical dilation > 5 cm
  • Clinical chorioamnionitis prior to initiation of second course (two or more of the following; antepartum temperature > 38ºC (100.4ºF), uterine tenderness, foul smelling vaginal discharge or amniotic fluid, maternal tachycardia (>100beats/min), fetal tachycardia (>160 beats/min), or white blood cell count >20x109/L.define)
  • Ruptured membranes prior to initiation of second course of betamethasone
  • Already receiving corticosteroids for other conditions (e.g. Lupus, asthma)
  • Maternal condition contraindicating the use of steroids (e.g. HIV, active Tuberculosis)
  • Participation in conflicting study
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00201643). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.

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