{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T17:53:49Z","timestamp":1773251629854,"version":"3.50.1"},"reference-count":41,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,2,1]]},"abstract":"<jats:p>BACKGROUND. A single dose of prenatal betamethasone treatment decreases neonatal morbidity rates when administered within 7 days before preterm delivery. A single repeat dose or booster dose of betamethasone before delivery has been proposed to be effective, but its efficacy has not been subjected to a randomized, blinded trial.<\/jats:p><jats:p>METHODS. Women with imminent delivery before 34.0 gestational weeks were eligible if they remained without delivery for &amp;gt;7 days after a single course of betamethasone. After stratification, a single repeat dose of betamethasone (12 mg) or placebo was administered. The primary outcome was survival without respiratory distress syndrome or severe intraventricular hemorrhage (grade 3 or 4).<\/jats:p><jats:p>RESULTS. A total of 249 mothers had been enrolled by the time the study was discontinued. All of the 159 infants in the betamethasone group and 167 in the placebo group were born before 36 weeks of gestation. The intact survival rate was unaffected and was lower than anticipated, because the gestational age-adjusted incidence of respiratory distress syndrome was higher than the population incidence. The requirement for surfactant therapy in respiratory distress syndrome was increased in the betamethasone group. According to posthoc analysis of the data for 206 infants who were delivered within 1 to 24 hours, the betamethasone booster tended to increase the risk of respiratory distress syndrome and to decrease intact survival rates.<\/jats:p><jats:p>CONCLUSIONS. According to this study, a single booster dose of betamethasone just before preterm birth may perturb respiratory adaptation. These results caution against uncontrolled use of a repeat dose of glucocorticoid in high-risk pregnancies.<\/jats:p>","DOI":"10.1542\/peds.2006-1549","type":"journal-article","created":{"date-parts":[[2007,2,3]],"date-time":"2007-02-03T06:46:57Z","timestamp":1170485217000},"page":"290-298","source":"Crossref","is-referenced-by-count":78,"title":["Randomized Trial of a Single Repeat Dose of Prenatal Betamethasone Treatment in Imminent Preterm Birth"],"prefix":"10.1542","volume":"119","author":[{"given":"Outi M.","family":"Peltoniemi","sequence":"first","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Anneli","family":"Kari","sequence":"additional","affiliation":[{"name":"Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Outi","family":"Tammela","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Tampere, Tampere, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liisa","family":"Lehtonen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Turku, Turku, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riitta","family":"Marttila","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Seina\u0308joki Central Hospital, Seina\u0308joki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erja","family":"Halmesma\u0308ki","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Helsinki, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pentti","family":"Jouppila","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology, University of Oulu, Oulu, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko","family":"Hallman","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Repeat Antenatal Betamethasone Study Group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2007,2,1]]},"reference":[{"key":"2021120901485766400_R1","doi-asserted-by":"crossref","unstructured":"Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics.\u20081972;50:515\u2013525","DOI":"10.1542\/peds.50.4.515"},{"key":"2021120901485766400_R2","unstructured":"Crowley P. Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev.\u20082000;(2): CD000065"},{"key":"2021120901485766400_R3","doi-asserted-by":"crossref","unstructured":"National Institutes of Health Consensus Development Panel on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. Effect of corticosteroids for fetal maturation on perinatal outcomes. JAMA.\u20081995;273:413\u2013418","DOI":"10.1001\/jama.273.5.413"},{"key":"2021120901485766400_R4","doi-asserted-by":"crossref","unstructured":"Ikegami M, Polk D, Jobe A. Minimum interval from fetal betamethasone treatment to postnatal lung responses in preterm lambs. Am J Obstet Gynecol.\u20081996;174:1408\u20131413","DOI":"10.1016\/S0002-9378(96)70581-1"},{"key":"2021120901485766400_R5","doi-asserted-by":"crossref","unstructured":"Wright LL, Verter J, Younes N, et al. Antenatal corticosteroid administration and neonatal outcome in very low birth weight infants: the NICHD Neonatal Research Network. Am J Obstet Gynecol.\u20081995;173:269\u2013274","DOI":"10.1016\/0002-9378(95)90212-0"},{"key":"2021120901485766400_R6","doi-asserted-by":"crossref","unstructured":"Elimian A, Figueroa R, Spitzer AR, et al. Antenatal corticosteroids: are incomplete courses beneficial?Obstet Gynecol.\u20082003;102:352\u2013355","DOI":"10.1097\/00006250-200308000-00025"},{"key":"2021120901485766400_R7","doi-asserted-by":"crossref","unstructured":"Polk DH, Ikegami M, Jobe AH, et al. Preterm lung function after retreatment with antenatal betamethasone in preterm lambs. Am J Obstet Gynecol.\u20081997;176:308\u2013315","DOI":"10.1016\/S0002-9378(97)70490-3"},{"key":"2021120901485766400_R8","doi-asserted-by":"crossref","unstructured":"Vermillion ST, Soper DE, Newman RB. Is betamethasone effective longer than 7 days after treatment?Obstet Gynecol.\u20082001;97:491\u2013493","DOI":"10.1097\/00006250-200104000-00002"},{"key":"2021120901485766400_R9","doi-asserted-by":"crossref","unstructured":"Banks BA, Cnaan A, Morgan MA, et al. Multiple courses of antenatal corticosteroids and outcome of premature neonates: North American Thyrotropin-Releasing Hormone Study Group. Am J Obstet Gynecol.\u20081999;181:709\u2013717","DOI":"10.1016\/S0002-9378(99)70517-X"},{"key":"2021120901485766400_R10","doi-asserted-by":"crossref","unstructured":"Abbasi S, Hirsch D, Davis J, et al. Effect of single versus multiple courses of antenatal corticosteroids on maternal and neonatal outcome. Am J Obstet Gynecol.\u20082000;182:1243\u20131249","DOI":"10.1067\/mob.2000.104789"},{"key":"2021120901485766400_R11","doi-asserted-by":"crossref","unstructured":"Sehdev HM, Abbasi S, Robertson P, et al. The effects of the time interval from antenatal corticosteroid exposure to delivery on neonatal outcome of very low birth weight infants. Am J Obstet Gynecol.\u20082004;191:1409\u20131413","DOI":"10.1016\/j.ajog.2004.06.055"},{"key":"2021120901485766400_R12","doi-asserted-by":"crossref","unstructured":"Garite TJ, Rumney PJ, Briggs GG, et al. A randomized, placebo-controlled trial of betamethasone for the prevention of respiratory distress syndrome at 24 to 28 weeks' gestation. Am J Obstet Gynecol.\u20081992;166:646\u2013651","DOI":"10.1016\/0002-9378(92)91691-3"},{"key":"2021120901485766400_R13","doi-asserted-by":"crossref","unstructured":"Chapman SJ, Hauth JC, Bottoms SF, et al. Benefits of maternal corticosteroid therapy in infants weighing \u22641000 grams at birth after preterm rupture of the amnion. Am J Obstet Gynecol.\u20081999;180:677\u2013682","DOI":"10.1016\/S0002-9378(99)70272-3"},{"key":"2021120901485766400_R14","doi-asserted-by":"crossref","unstructured":"Guinn DA, Atkinson MW, Sullivan L, et al. Single vs weekly courses of antenatal corticosteroids for women at risk of preterm delivery: a randomized controlled trial. JAMA.\u20082001;286:1581\u20131587","DOI":"10.1001\/jama.286.13.1581"},{"key":"2021120901485766400_R15","doi-asserted-by":"crossref","unstructured":"McEvoy C, Bowling S, Williamson K, et al. The effect of a single remote course versus weekly courses of antenatal corticosteroids on functional residual capacity in preterm infants: a randomized trial. Pediatrics.\u20082002;110:280\u2013284","DOI":"10.1542\/peds.110.2.280"},{"key":"2021120901485766400_R16","doi-asserted-by":"crossref","unstructured":"Vermillion ST, Bland ML, Soper DE. Effectiveness of a rescue dose of antenatal betamethasone after an initial single course. Am J Obstet Gynecol.\u20082001;185:1086\u20131089","DOI":"10.1067\/mob.2001.117633"},{"key":"2021120901485766400_R17","doi-asserted-by":"crossref","unstructured":"Vermillion ST, Soper DE, Newman RB. Neonatal sepsis and death after multiple courses of antenatal betamethasone therapy. Am J Obstet Gynecol.\u20082000;183:810\u2013814","DOI":"10.1067\/mob.2000.108838"},{"key":"2021120901485766400_R18","doi-asserted-by":"crossref","unstructured":"Bloom SL, Sheffield JS, McIntire DD, Leveno KJ. Antenatal dexamethasone and decreased birth weight. Obstet Gynecol.\u20082001;97:485\u2013490","DOI":"10.1097\/00006250-200104000-00001"},{"key":"2021120901485766400_R19","doi-asserted-by":"crossref","unstructured":"Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr.\u20081978;92:529\u2013534","DOI":"10.1016\/S0022-3476(78)80282-0"},{"key":"2021120901485766400_R20","doi-asserted-by":"crossref","unstructured":"de Vries LS, Eken P, Dubowitz LM. The spectrum of leukomalacia using cranial ultrasound. Behav Brain Res.\u20081992;49:1\u20136","DOI":"10.1016\/S0166-4328(05)80189-5"},{"key":"2021120901485766400_R21","doi-asserted-by":"crossref","unstructured":"Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg.\u20081978;187:1\u20137","DOI":"10.1097\/00000658-197801000-00001"},{"key":"2021120901485766400_R22","unstructured":"Kari MA, Hallman M, Eronen M, et al. Prenatal dexamethasone treatment in conjunction with rescue therapy of human surfactant: a randomized placebo-controlled multicenter study. Pediatrics.\u20081994;93:730\u2013736"},{"key":"2021120901485766400_R23","doi-asserted-by":"crossref","unstructured":"Schutte MF, Treffers PE, Koppe JG, Breur W. The influence of betamethasone and orciprenaline on the incidence of respiratory distress syndrome in the newborn after preterm labour. Br J Obstet Gynaecol.\u20081980;87:127\u2013131","DOI":"10.1111\/j.1471-0528.1980.tb04505.x"},{"key":"2021120901485766400_R24","doi-asserted-by":"crossref","unstructured":"Ikegami M, Jobe AH, Newnham J, et al. Repetitive prenatal glucocorticoids improve lung function and decrease growth in preterm lambs. Am J Respir Crit Care Med.\u20081997;156:178\u2013184","DOI":"10.1164\/ajrccm.156.1.9612036"},{"key":"2021120901485766400_R25","doi-asserted-by":"crossref","unstructured":"Nie M, Knox AJ, Pang L. \u03b22-Adrenoceptor agonists, like glucocorticoids, repress eotaxin gene transcription by selective inhibition of histone H4 acetylation. J Immunol.\u20082005;175:478\u2013486","DOI":"10.4049\/jimmunol.175.1.478"},{"key":"2021120901485766400_R26","doi-asserted-by":"crossref","unstructured":"Kallapur SG, Kramer BW, Moss TJ, et al. Maternal glucocorticoids increase endotoxin-induced lung inflammation in preterm lambs. Am J Physiol Lung Cell Mol Physiol.\u20082003;284:L633\u2013L642","DOI":"10.1152\/ajplung.00344.2002"},{"key":"2021120901485766400_R27","doi-asserted-by":"crossref","unstructured":"Ng PC, Wong GW, Lam CW, et al. Pituitary-adrenal response in preterm very low birth weight infants after treatment with antenatal corticosteroids. J Clin Endocrinol Metab.\u20081997;82:3548\u20133552","DOI":"10.1210\/jcem.82.11.4392"},{"key":"2021120901485766400_R28","doi-asserted-by":"crossref","unstructured":"Arnold JD, Bonacruz G, Leslie GI, et al. Antenatal glucocorticoids modulate the amplitude of pulsatile cortisol secretion in premature neonates. Pediatr Res.\u20081998;44:876\u2013881","DOI":"10.1203\/00006450-199812000-00009"},{"key":"2021120901485766400_R29","doi-asserted-by":"crossref","unstructured":"Dorr HG, Versmold HT, Sippell WG, et al. Antenatal betamethasone therapy: effects on maternal, fetal, and neonatal mineralocorticoids, glucocorticoids, and progestins. J Pediatr.\u20081986;108:990\u2013993","DOI":"10.1016\/S0022-3476(86)80946-5"},{"key":"2021120901485766400_R30","doi-asserted-by":"crossref","unstructured":"Ballard PL, Gluckman PD, Liggins GC, et al. Steroid and growth hormone levels in premature infants after prenatal betamethasone therapy to prevent respiratory distress syndrome. Pediatr Res.\u20081980;14:122\u2013127","DOI":"10.1203\/00006450-198002000-00011"},{"key":"2021120901485766400_R31","doi-asserted-by":"crossref","unstructured":"Ballard PL, Granberg P, Ballard RA. Glucocorticoid levels in maternal and cord serum after prenatal betamethasone therapy to prevent respiratory distress syndrome. J Clin Invest.\u20081975;56:1548\u20131554","DOI":"10.1172\/JCI108236"},{"key":"2021120901485766400_R32","doi-asserted-by":"crossref","unstructured":"Banks BA, Stouffer N, Cnaan A, et al. Association of plasma cortisol and chronic lung disease in preterm infants. Pediatrics.\u20082001;107:494\u2013498","DOI":"10.1542\/peds.107.3.494"},{"key":"2021120901485766400_R33","doi-asserted-by":"crossref","unstructured":"Huysman MWA, Hokken-Koelega ACS, De Ridder MAJ, Sauer PJ. Adrenal function in sick very preterm infants. Pediatr Res.\u20082000;48:629\u2013633","DOI":"10.1203\/00006450-200011000-00013"},{"key":"2021120901485766400_R34","doi-asserted-by":"crossref","unstructured":"Ervin MG, Padbury JF, Polk DH, et al. Antenatal glucocorticoids alter premature newborn lamb neuroendocrine and endocrine responses to hypoxia. Am J Physiol Regul Integr Comp Physiol.\u20082000;279:R830\u2013R838","DOI":"10.1152\/ajpregu.2000.279.3.R830"},{"key":"2021120901485766400_R35","doi-asserted-by":"crossref","unstructured":"Scott SM, Watterberg KL. Effect of gestational age, postnatal age, and illness on plasma cortisol concentrations in premature infants. Pediatr Res.\u20081995;37:112\u2013116","DOI":"10.1203\/00006450-199501000-00021"},{"key":"2021120901485766400_R36","doi-asserted-by":"crossref","unstructured":"Kramer BW, Ikegami M, Moss TJ, et al. Antenatal betamethasone changes cord blood monocyte responses to endotoxin in preterm lambs. Pediatr Res.\u20082004;55:764\u2013768","DOI":"10.1203\/01.PDR.0000120678.72485.19"},{"key":"2021120901485766400_R37","doi-asserted-by":"crossref","unstructured":"Jobe AH, Ikegami M. Pathophysiology of respiratory distress syndrome and surfactant metabolism. In: Polin RA, Fox WW, Abman SH, eds. Fetal and Neonatal Physiology. 3rd ed. Philadelphia, PA: Saunders; 2004: 1055\u20131068","DOI":"10.1016\/B978-0-7216-9654-6.50107-7"},{"key":"2021120901485766400_R38","doi-asserted-by":"crossref","unstructured":"Vayrynen O, Glumoff V, Hallman M. Inflammatory and anti-inflammatory responsiveness of surfactant proteins in fetal and neonatal rabbit lung. Pediatr Res.2004;55:55\u201360","DOI":"10.1203\/01.PDR.0000100462.41671.C6"},{"key":"2021120901485766400_R39","doi-asserted-by":"crossref","unstructured":"Crowther C, Haslma RR, Hiller JE, et al. Neonatal respiratory distress syndrome after repeat exposure to antenatal corticosteroids: a randomised controlled trial. Lancet.\u20082006;367:1913\u20131919","DOI":"10.1016\/S0140-6736(06)68846-6"},{"key":"2021120901485766400_R40","doi-asserted-by":"crossref","unstructured":"Vohr BR, Wright LL, Dusick AM, et al. Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993\u20131994. Pediatrics.\u20082000;105:1216\u20131226","DOI":"10.1542\/peds.105.6.1216"},{"key":"2021120901485766400_R41","doi-asserted-by":"crossref","unstructured":"French NP, Hagan R, Evans SF, Godfrey M, Newnham JP. Repeated antenatal corticosteroids: size at birth and subsequent development. Am J Obstet Gynecol.\u20081999;180:114\u2013121","DOI":"10.1016\/S0002-9378(99)70160-2"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/119\/2\/290\/1118612\/zpe00207000290.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/119\/2\/290\/1118612\/zpe00207000290.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T16:17:24Z","timestamp":1683735444000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/119\/2\/290\/70320\/Randomized-Trial-of-a-Single-Repeat-Dose-of"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,2,1]]},"references-count":41,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2007,2,1]]},"published-print":{"date-parts":[[2007,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2006-1549","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,2,1]]}}}