Single versus weekly courses of antenatal corticosteroids in preterm premature rupture of membranes

Obstet Gynecol. 2004 Feb;103(2):274-81. doi: 10.1097/01.AOG.0000110249.84858.90.


Objective: This study was performed to evaluate the efficacy of weekly courses of antenatal corticosteroids compared with a single course in women with preterm premature rupture of membranes (PROM).

Methods: A planned secondary analysis of women with preterm PROM who participated in a multicenter, randomized trial of weekly courses of antenatal corticosteroids versus single-course therapy was performed. After their first course of standard antenatal steroid therapy, administered between 24 to 32-6/7 weeks of gestation, consenting women were randomly assigned to receive betamethasone versus placebo injections weekly until 34-0/7 weeks of gestation. Maternal and neonatal morbidities were compared between the 2 groups.

Results: Of the 161 women with preterm PROM, 81 women were assigned to receive weekly courses of steroids and 80 to the single-course group. There were no significant differences in composite morbidity between the groups (27 [34.2%] of 81 patients versus 33 [41.8%] of 80 patients, P =.41). Chorioamnionitis was higher in patients who received weekly courses of antenatal steroids (39 [49.4%] of 81 patients versus 25 [31.7%] of 80 patients, P =.04).

Conclusion: Weekly courses of antenatal steroids in women with preterm PROM did not improve neonatal outcomes beyond that achieved with single-course therapy and was associated with an increased risk of chorioamnionitis. Antenatal steroid therapy should not be routinely repeated in patients with preterm PROM.

Level of evidence: I

Publication types

  • Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Betamethasone / administration & dosage*
  • Dexamethasone / administration & dosage*
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Fetal Membranes, Premature Rupture / drug therapy*
  • Fetal Membranes, Premature Rupture / prevention & control
  • Follow-Up Studies
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Injections, Intramuscular
  • Maternal Age
  • Pregnancy
  • Pregnancy Outcome*
  • Pregnancy, High-Risk
  • Prenatal Care / methods
  • Probability
  • Risk Assessment
  • Treatment Outcome


  • Dexamethasone
  • Betamethasone