Betamethasone for Preterm Labor

Babies have a “lease” on the womb for at least 37-40 weeks. If they’re forced out before then, they may not be ready. Health issues like trouble breathing can put their lives in danger. That’s why doctors sometimes prescribe betamethasone for women in preterm labor. 

Betamethasone isn’t the only treatment that helps women in premature labor. But it’s one of the most common. Here, we’ll tell you what it is, how it works, and what the benefits and risks of taking it are.

What is Betamethasone?

Children born prematurely (before 37 weeks of gestational age) can face serious developmental challenges. Preterm infants often have underdeveloped organs, especially the lungs. Poor fetal lung maturation can make them susceptible to conditions like neonatal respiratory distress syndrome (RDS). This is why doctors try to prevent premature births as much as possible. 

But sometimes premature births can’t be prevented. So a physician might prescribe certain treatments to improve neonatal outcomes, drugs that help a baby mature faster than usual. Antenatal corticosteroids (AKA prenatal corticosteroids) help develop the lungs of a fetus. In fact, antenatal corticosteroid administration can save a baby’s life.

One type of these antenatal steroids is betamethasone. Betamethasone is a type of antenatal corticosteroid therapy that’s useful for a wide variety of ailments, thanks to its anti-inflammatory and immunosuppressive properties. It can treat many medical conditions, from skin problems to asthma. The administration of betamethasone to pregnant women at risk of preterm birth is called antenatal corticosteroid therapy.

Betamethasone is a common treatment for pregnant women who are at risk of premature birth. Doctors inject it into the mother’s arm, leg, or buttocks. It enters the mother’s bloodstream and eventually reaches the baby. Once it circulates through the baby’s bloodstream, it reduces the risk of some very serious health problems. 

Why Do Doctors Prescribe Betamethasone for Women In Preterm Labor?

The main reason is its efficacy in accelerating fetal lung maturation. It stimulates the production of surfactant, a substance that lines the air sacs in the lungs and helps them inflate properly. Surfactant production is important for lung function. But premature infants often don’t have enough of it. Overall, it helps reduce complications in the newborn if preterm birth is imminent.

Betamethasone also reduces these preterm birth risks: 

• Respiratory problems
• Brain bleeds
• Necrotizing enterocolitis (severe intestinal infection)
• Hypoxic-ischemic encephalopathy (HIE)
• Cerebral palsy
• Periventricular leukomalacia
• Neonatal mortality/death (by about 40%)

Risks of Betamethasone Treatment

The risks associated with betamethasone are minimal, as long as doctors administer it correctly. Research has shown that multiple courses of corticosteroids can cause babies to have low birth weight and smaller heads. So nowadays, doctors recommend just one or two courses. 

A course would include two doses of 12 milligrams (mg) each, 12 or 24 hours apart. The drug is most effective when taken 2-7 days before the baby’s birth. 

The American College of Obstetricians and Gynecologists (ACOG) has set the following guidelines for the safe use of betamethasone for women in preterm labor:

• 23-34 weeks of gestation: If the woman is at risk of giving birth within a week, give a single course of corticosteroids. 
• 34-37 weeks of gestation: If the woman is at risk of giving birth within a week, give a single course of corticosteroids if she hasn’t already had one. 
• Less than 34 weeks of gestation: If the woman is at risk of giving birth within a week, give a second course of corticosteroids if 14 days have passed since the first one. (In some cases, after 7 days have passed). 

Physicians need to treat each case as unique. Some women shouldn’t take corticosteroids, such as those with chorioamnionitis (an infection in the womb). Others should take them with caution, like mothers with diabetes. Betamethasone may make diabetes harder to keep under control. 

Other Treatments for Preterm Birth Infants

Betamethasone isn’t the only intervention available to help prevent complications from preterm delivery. 

Here are other treatment methods a doctor might prescribe in addition to or instead of betamethasone:

• Medication to prevent preterm labor (like terbutaline and brethine)
• Progesterone regimen to lower the chances of premature birth
• Cervical cerclage (for women with incompetent cervix)
• Surfactant therapy after the baby is born
• Respiratory support after birth (such as mechanical ventilation or continuous positive airway pressure (CPAP)
• Temperature regulation (such as an incubator)
• A longer hospital stay to monitor for infections and complications
• Intravenous (IV) nutrition (for babies that can’t tolerate oral feeding)
• Jaundice treatment (Jaundice is common in premature babies) 

Doctors should prescribe treatment based on the mother/baby’s individual needs and the healthcare team’s assessment of their condition. If a physician fails to provide proper care, that’s medical negligence. If their negligence causes a birth injury, it’s medical malpractice. 

Did your doctor mismanage your pregnancy or delivery? Did they fail to offer betamethasone for preterm labor? Was your child permanently injured as a result? Don’t turn a blind eye to your doctor’s mistakes. Children living with permanent disabilities require lifelong medical care, and it’s no picnic. We have helped countless families obtain compensation to pay for treatment. We can help yours, too! Call us now to discuss your case.