A Comparative Study of the Respiratory Neonatal Outcomes Utilizing Dexamethasone Sodium Phosphate versus a Mixture of Betamethasone Dipropionate and Betamethasone Sodium Phosphate as an Antenatal Corticosteroid Therapy

Figures & data

Table 1 Maternal and Neonatal Demographic Characteristics

Variables	Total (n = 650)	B-DP/SP (n = 165)	DSP (n = 485)	P-value
Maternal age	30.5 ± 5.6	30.9 ± 5.7	30.3 ± 5.6	0.264
Gestational age (Mean, IQR^a)	34.2 (2.8)	34.5 (2.5)	34.2 (2.9)	0.161
Extremely preterm	24 (3.7)	7 (4.2)	17 (3.5)
Very preterm	89 (13.7)	16 (9.7)	73 (15.1)
Moderate or late preterm	537 (82.6)	142 (86.1)	395 (81.4)
Neonatal gender				0.162
Males	307 (50.3)	85 (55.2)	222 (48.7)
Females	303 (49.7)	69 (44.8)	234 (51.3)
Number of gestations				0.003
Singleton	347 (55.3)	96 (60.4)	251 (53.6)
Twins	196 (31.3)	42 (26.4)	154 (32.9)
Triplets	72 (11.5)	13 (8.2)	59 (12.6)
Quadruplets	12 (1.9)	8 (5.0)	4 (0.9)
Birth weight in grams	2049.7 ± 572.0	2053.0 ± 565.9	2048.6 ± 574.7	0.085
Mode of delivery				0.422
Cesarean section	541 (83.2)	134 (81.2)	407 (83.9)
Vaginal delivery	109 (16.8)	31 (18.8)	78 (16.1)
Elective vs Emergency				0.040
Elective	108 (20.2)	19 (14.1)	89 (22.3)
Emergency	426 (79.8)	116 (85.9)	310 (77.7)
Anesthesia in cesarean section				0.291
General anesthesia	184 (37.3)	41 (33.3)	143 (38.6)
Spinal anesthesia	309 (62.7)	82 (66.7)	227 (61.4)
Anesthesia in vaginal delivery				1.000
Epidural	20 (58.8)	5 (62.5)	15 (57.7)
Morphine	14 (41.2)	3 (37.5)	11 (42.3)
Maternal comorbidities
Chronic hypertension	14 (2.2)	3 (1.8)	11 (2.3)	1.000
Gestational hypertension	14 (2.2)	7 (4.2)	7 (1.4)	0.055
Pre-eclampsia	42 (6.5)	13 (7.9)	29 (6.0)	0.391
Gestational diabetes	25 (3.8)	12 (7.3)	13 (2.7)	0.008
Diabetes mellitus	12 (1.8)	2 (1.2)	10 (2.1)	0.740
Hypothyroidism	17 (2.6)	3 (1.8)	14 (2.9)	0.581
Thrombophilia	16 (2.5)	6 (3.6)	10 (2.1)	0.255
Abruptio placenta	33 (5.1)	8 (4.8)	25 (5.2)	0.877
Placenta previa	14 (2.2)	3 (1.8)	11 (2.3)	1.000
Polyhydramnios	4 (0.6)	1 (0.6)	3 (0.6)	1.000
Oligohydramnios	11 (1.7)	5 (3.0)	6 (1.2)	0.158
Maternal HBsAg^b	5 (0.8)	1 (0.6)	4 (0.8)	1.000
Premature rupture of membranes	184 (28.4)	46 (27.9)	138 (28.6)	0.853
Chorioamnionitis	14 (2.2)	6 (3.6)	8 (1.7)	0.210

Notes: Data are presented as mean ± standard deviation (SD) or frequency (percentage). ^aInterquartile range. ^bReactive Hepatitis B surface antigen.

Table 2 A Comparative Analysis of the Respiratory Neonatal Outcomes and Therapeutic Interventions Between DSP and B-DP/SP in Very Preterm Neonates

Variables	Very Preterm (n = 89)
	B-DP/SP (n = 16)	DSP (n = 73)	P-value
Respiratory distress syndrome	13 (81.3)	68 (93.2)	0.151
Apnea of prematurity	1 (6.3)	17 (23.3)	0.176
Transient tachypnea of the newborn	0 (0.0)	0 (0.0)	*
Chronic lung disease			0.046
No	15 (93.8)	50 (69.4)
Mild	1 (6.3)	12 (16.7)
Moderate	0 (0.0)	10 (13.9)
Severe	0 (0.0)	0 (0.0)
Pneumothorax	1 (6.3)	3 (4.2)	0.563
Congenital pneumonia	0 (0.0)	0 (0.0)	*
Pulmonary hemorrhage	0 (0.0)	1 (1.4)	1.000
Pulmonary hypertension	0 (0.0)	0 (0.0)	*
Meconium aspiration	0 (0.0)	1 (3.3)	1.000
Birth weight in grams	1336.9 ± 425.5	1419.5 ± 324.5	0.499
Birth Depression	0 (0.0)	7 (9.6)	0.343
Small for gestational age	8 (50.0)	24 (32.9)	0.196
Large for gestational age	0 (0.0)	1 (1.4)	1.000
Apgar score at 5 minutes	8.2 ± 0.8	8.0 ± 1.4	0.564
Number of surfactant dosages			0.227
0	7 (50.0)	18 (24.7)
1	3 (21.4)	33 (45.2)
2	3 (21.4)	14 (19.2)
3	1 (7.1)	8 (11.0)
4	0 (0.0)	0 (0.0)
Use of aminophylline	8 (50.0)	47 (64.4)	0.284
Inhaled steroids	6 (37.5)	35 (47.9)	0.448
DART^a	1 (6.3)	9 (12.3)	0.683
Days on CMV^b	1.9 ± 3.0	5.7 ± 8.2	0.022
Days on CPAP^c	7.6 ± 5.7	14.9 ± 12.1	< 0.001
Days on HFNC^d	0.0 ± 0.0	1.9 ± 5.7	0.33
Length of stay in days	28.1 ± 10.5	34.8 ± 21.4	0.059
Mortality (Alive percentage)	15 (93.8)	63 (86.3)	0.681

Notes: Data are presented as mean ± standard deviation (SD) or frequency (percentage) within B-DP/SP and DSP groups. *Cannot generate a P-value due to insufficient data. ^aDexamethasone: A Randomized Trial. ^bContinuous mandatory ventilation. ^cContinuous positive airway pressure. ^dHigh flow nasal cannula.

Table 3 A Comparative Analysis of the Respiratory Neonatal Outcomes and Therapeutic Interventions Between DSP and B-DP/SP in Very Preterm Neonates

Variables	Moderate or Late Preterm (n = 537)
	B-DP/SP (n = 142)	DSP (n = 395)	P-value
Respiratory distress syndrome	42 (29.6)	172 (43.9)	0.003
Apnea of prematurity	7 (4.9)	36 (9.2)	0.107
Transient tachypnea of the newborn	11 (7.7)	26 (6.6)	0.654
Chronic lung disease			0.603
No	140 (98.6)	382 (98.2)
Mild	1 (0.7)	4 (4.0)
Moderate	1 (0.7)	1 (0.3)
Severe	0 (0.0)	2 (0.5)
Pneumothorax	0 (0.0)	2 (0.5)	1.000
Congenital pneumonia	0 (0.0)	0 (0.0)	*
Pulmonary hemorrhage	1 (0.7)	0 (0.0)	0.267
Pulmonary hypertension	0 (0.0)	0 (0.0)	*
Meconium aspiration	4 (7.8)	2 (1.4)	0.046
Birth weight in grams	2191.2 ± 455.3	2219.1 ± 466.3	0.519
Birth Depression	3 (2.1)	11 (2.8)	0.769
Small for gestational age	43 (30.3)	119 (30.1)	0.972
Large for gestational age	3 (2.1)	6 (1.5)	0.705
Apgar score at 5 minutes	8.6 ± 1.1	8.6 ± 1.0	0.983
Number of surfactant dosages			0.101
0	72 (78.3)	174 (70.2)
1	16 (17.4)	58 (23.4)
2	3 (3.3)	11 (4.4)
3	0 (0.0)	5 (2.0)
4	1 (1.1)	0 (0.0)
Use of aminophylline	1 (0.7)	12 (3.1)	0.201
Inhaled steroids	4 (2.8)	36 (9.2)	0.014
DART^a	2 (1.4)	4 (1.0)	0.659
Days on CMV^b	0.5 ± 2.0	0.9 ± 3.6	0.646
Days on CPAP^c	2.4 ± 4.6	3.8 ± 4.9	0.051
Days on HFNC^d	0.2 ± 1.0	0.3 ± 1.8	0.651
Length of stay in days	8.7 ± 10.8	9.6 ± 9.2	0.510
Mortality (Alive percentage)	138 (97.9)	377 (96.7)	0.578

Notes: Data are presented as mean ± standard deviation (SD) or frequency (percentage) within B-DP/SP and DSP groups. *Cannot generate a P-value due to insufficient data. ^aDexamethasone: A Randomized Trial. ^bContinuous mandatory ventilation. ^cContinuous positive airway pressure. ^dHigh flow nasal cannula.