Research Obstetrics| Volume 203, ISSUE 1, P47.e1-47.e5, July 2010

Administration of steroids after 34 weeks of gestation enhances fetal lung maturity profiles


      To estimate the effect of antenatal glucocorticoid administration on fetal lung maturity in pregnancies with known fetal lung immaturity between the 34th and 37th weeks of gestation.

      Study Design

      Pregnancies between 340/7 and 366/7 weeks undergoing amniocentesis to determine fetal lung maturity were targeted. Women with negative results (TDx-FLM-II <45 mg/g) were randomly assigned to intramuscular glucocorticoid injection or no treatment. A repeat TDx-FLM-II test was obtained 1 week after enrollment.


      Thirty-two women who met inclusion criteria were randomly assigned. Seven women delivered within a week of testing for fetal lung maturity, and were excluded from the analysis. Ten received glucocorticoid and 15 did not. Women assigned to glucocorticoids had a mean increase TDx-FLM-II in 1 week of 28.37 mg/g. Women assigned to no-treatment had an increase of 9.76 mg/g (P < .002).


      A single course of intramuscular glucocorticoids after 34 weeks in pregnancies with documented fetal lung immaturity significantly increases TDx- FLM-II.

      Key words

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        • Martin J.A.
        • Kung H.C.
        • Mathews T.J.
        • et al.
        Annual summary of vital statistics: 2006.
        Pediatrics. 2008; 121: 788-801
        • Roberts D.
        • Dalziel S.
        Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth.
        Cochrane database of systematic reviews (Online). 2006; 3 (CD004454)
        • American College of Obstetricians and Gynecologists
        ACOG committee opinion no. 402: antenatal corticosteroid therapy for fetal maturation.
        Obstet Gynecol. 2008; 111: 805-807
        • Crowley P.A.
        Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994.
        Am J Obstet Gynecol. 1995; 173: 322-335
        • Robertson P.A.
        • Sniderman S.H.
        • Laros Jr, R.K.
        • et al.
        Neonatal morbidity according to gestational age and birth weight from five tertiary care centers in the United States, 1983 through 1986.
        Am J Obstet Gynecol. 1992; 166 (discussion 41-5): 1629-1641
        • American College of Obstetricians and Gynecologists
        ACOG committee opinion no. 404 April 2008.
        Obstet Gynecol. 2008; 111: 1029-1032
        • American College of Obstetricians and Gynecologists
        ACOG practice bulletin no. 97.
        Obstet Gynecol. 2008; 112: 717-726
        • Bildirici I.
        • Moga C.N.
        • Gronowski A.M.
        • Sadovsky Y.
        The mean weekly increment of amniotic fluid TDx-FLM II ratio is constant during the latter part of pregnancy.
        Am J Obstet Gynecol. 2005; 193: 1685-1690
        • Gluck L.
        • Kulovich M.V.
        • Borer Jr, R.C.
        • Brenner P.H.
        • Anderson G.G.
        • Spellacy W.N.
        Diagnosis of the respiratory distress syndrome by amniocentesis.
        Am J Obstet Gynecol. 1995; 173 (1971) (discussion 30): 629
        • Garite T.J.
        Fetal maturity testing.
        Clin Obstet Gynecol. 1987; 30: 985-991
        • Ashwood E.R.
        • Palmer S.E.
        • Taylor J.S.
        • Pingree S.S.
        Lamellar body counts for rapid fetal lung maturity testing.
        Obstet Gynecol. 1993; 81: 619-624
        • Lewis P.S.
        • Lauria M.R.
        • Dzieczkowski J.
        • Utter G.O.
        • Dombrowski M.P.
        Amniotic fluid lamellar body count: cost-effective screening for fetal lung maturity.
        Obstet Gynecol. 1999; 93: 387-391
        • Hagen E.
        • Link J.C.
        • Arias F.
        A comparison of the accuracy of the TDx-FLM assay, lecithin-sphingomyelin ratio, and phosphatidylglycerol in the prediction of neonatal respiratory distress syndrome.
        Obstet Gynecol. 1993; 82: 1004-1008
        • Fantz C.R.
        • Powell C.
        • Karon B.
        • et al.
        Assessment of the diagnostic accuracy of the TDx-FLM II to predict fetal lung maturity.
        Clin Chemistry. 2002; 48: 761-765
        • Moore T.R.
        A comparison of amniotic fluid fetal pulmonary phospholipids in normal and diabetic pregnancy.
        Am J Obstet Gynecol. 2002; 186: 641-650
        • Robert M.F.
        • Neff R.K.
        • Hubbell J.P.
        • Taeusch H.W.
        • Avery M.E.
        Association between maternal diabetes and the respiratory-distress syndrome in the newborn.
        N Engl J Med. 1976; 294: 357-360
        • Kulovich M.V.
        • Gluck L.
        The lung profile: II, complicated pregnancy.
        Am J Obstet Gynecol. 1979; 135: 64-70