Comparative Study of the Safety and Efficacy of Intramuscular Dexamethasone, Betamethasone Phosphate, and Standard Management Protocol in Early-Term Scheduled Caesarean Delivery

Background Babies born between 37 weeks +0 days and 38 weeks +6 days by scheduled caesarean delivery before the onset of labour are more prone to developing respiratory complications than babies delivered between 39 weeks +0 days and 40 weeks +0 days. Antenatal corticosteroids have been used in preterm births for lung maturity. The advantages of administering antenatal corticosteroids before a scheduled caesarean delivery in the early term remain a subject of debate. While some studies have reported benefits, including a reduction in respiratory issues, the evidence is still inconclusive. The study's main objective is to compare the efficacy and safety of intramuscular dexamethasone and betamethasone phosphate with standard treatment protocols in early-term infants. Methodology A total of 241 pregnant women scheduled for caesarean delivery were screened for eligibility to participate in the study. Out of these, 192 women met the inclusion criteria and were enrolled in the study after providing written informed consent; they were randomised into three groups, with 64 in each group, and were given either betamethasone phosphate or dexamethasone intramuscularly or were considered under standard management protocol (no administration of corticosteroids). The primary comparison was done to observe the development of respiratory distress syndrome, transient tachypnoea in newborns, and the need for neonatal intensive care unit (NICU) admission. Results Among 192 pregnant females observed, the incidence of development of respiratory distress syndrome did not differ significantly between the betamethasone, dexamethasone, and standard management groups, with rates of 6.25%, 7.81%, and 4.7%, respectively. Additionally, out of the 192 infants, 15 required neonatal intensive care, including 6 (9.4%) from the betamethasone group, 5 (7.8%) from the dexamethasone group, and 4 (6.3%) from the standard management group. All of these infants had a maximum stay of four days in the NICU, did not require mechanical support, and improved with oxygen therapy. Conclusion In our study, in early-term gestation, both the corticosteroid groups showed similar effects to those of the standard management group in reducing neonatal morbidity, with no significant statistical difference. Hence, the choice lies with the treating obstetrician to consider the administration of corticosteroids in early-term caesarean deliveries.