Antenatal corticosteroids and incidence of neonatal respiratory distress after elective caesarean section in late preterm and term neonates

Introduction: Birth by elective caesarean section in late preterm and early term newborn increases the risk of respiratory distress. Administration of antenatal corticosteroids in these cases could reduce the respiratory distress and its severity. Objectives: To determine the influence of antenatal corticosteroids use in elective caesarean sections in the respiratory distress of the newborn from 35+0 to 38+6 weeks of gestational age. Patients and methods: Retrospective analytical study of caesarean sections from 35+0 to 38+6 gestational age was conducted in a tertiary hospital from January 2013 to April 2017. Data were collected from medical records of pregnant women and newborns after an implementation of new protocol of betamethasone administration to these elective caesarean sections. Analysis was performed on 2 newborn subgroups: preterm newborn (PTN) 35-36 gestational age and term (TN) 37-38 weeks. Results: A total of 208 elective caesarean sections were performed in the study period. Corticosteroids were administered in 97 (46.6%) of cases. The percentage of respiratory distress was higher in the group of preterm newborn compared to term newborn (29% vs. 8.8%, P<.001) and in term newborn higher at a lower gestational age. Between treated with corticosteroids or not, no significant differences were found in the treated and non-treated in the development of respiratory distress (PTN 30 vs. 30%, TN 9.1 vs. 6.9%, P=.6). Conclusions: No statistically significant differences were found in this study in favour of the administration of an antenatal dose of betamethasone in the reduction of respiratory distress in the elective caesarean sections from 35+0 to 38+6 gestational age. The delay in the indication of elective caesarean sections, whenever possible, could help reduce the incidence of newborn respiratory distress. (C) 2019 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.