***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE . We compared the development of adverse neurodevelopmental outcomes at corrected ages of 18 to 22 months for extremely low birth weight infants exposed prenatally to dexamethasone , betamethasone , or no steroid .  METHODS . Study infants were extremely low birth weight ( 401–1000 g ) infants who were in the care of National Institute of Child Health and Human Development Neonatal Research Network centers between January 1 , 2002 , and April 30 , 2003 ; they were assessed neurodevelopmentally at corrected ages of 18 to 22 months . Outcomes were defined as Bayley Scales of Infant Development-II Mental Development Index of < 70 , Bayley Scales of Infant Development-II Psychomotor Development Index of < 70 , bilateral blindness , bilateral hearing aid use , cerebral palsy , and neurodevelopmental impairment . Neurodevelopmental impairment was defined as ≥1 of the aforementioned outcomes . RESULTS . A total of 1124 infants met entry criteria . There were no statistically significant associations between prenatal dexamethasone exposure and any follow-up outcome , compared with no prenatal steroid exposure . Prenatal betamethasone exposure was associated with reduced risks of hearing impairment and neurodevelopmental impairment and with increased likelihood of unimpaired status , compared with no prenatal steroid exposure . Compared with betamethasone , dexamethasone was associated with a trend for increased risk of Psychomotor Development Index of < 70 , increased risk of hearing impairment , and decreased likelihood of unimpaired status . CONCLUSIONS . Prenatal betamethasone exposure was associated with increased likelihood of unimpaired neurodevelopmental status and reduced risk of hearing impairment at corrected ages of 18 to 22 months among extremely low birth weight infants , compared with prenatal dexamethasone exposure or no prenatal steroid exposure . Pending a r and omized , clinical trial , it may be in the best interests of infants to receive betamethasone , rather than dexamethasone , when possible This study aim ed to monitor the change of practice in  antenatal corticosteroids use in  preterm birth  , assess how physicians would prescribe and identify factors associated with such a prescription . Medical records were review ed quantitatively and current attending physicians were interviewed qualitatively . Multiple logistic regression with r and om effect model was used for analysis . The results revealed that  antenatal corticosteroid use in preterm births initially doubled after the evidence became available and tripled after the evidence was disseminated . The  antenatal corticosteroid use among  women having a gestational age less than 34 weeks  increased significantly from 41 % to 71 % and 73 % , respectively ( p < 0.01 ) . A gestational age of 34 weeks or more or a higher cervical dilatation at admission reduced the use of corticosteroids significantly . In conclusion , physician 's practice changed based on the evidence . The education for the early recognition of labor and guidelines on the use of antenatal corticosteroids should be implemented Objective To compare the bioavilability of oral and intramuscular ( IM ) dexamthasonei in third-trimester pregnant women . Methods Oral and IM dexamethasone levels were compared in a r and omized , parallel , crossover bioavailability study involving 11 gravid women in the third trimester of pregnancy . Subjects were r and omized to receive either 6 mg of IM or 8 mg of oral dexamethasone . The following week , the alternative regimen was administered . Serial blood sample s were obtained after drug administration . Dexamethasone concentrations were measured by radioimmunoassay . Total area under the curve was compared for the oral and IM groups using a paired t test . Results Eight of the 11 women completed the study through 12 hours ; all 11 women completed the study through 6 hours . Among the 11 women , peak levels of dexamethasone  occurred 30 minutes after IM injection ( mean ± st and ardf deviation , 101.7 ± 19.2 ng/mL ) and 120 minutes after oral administration ( 65.9 ± 20.5 ng/mL ) . Area under the curve did not differ significantly between those receiving IM dexamethasone ( 258.3 ± 50.0 ng/minu/mL ) when measured 6 hours after administration of the drug . Terminal half-lives were similar in the IM and oral groups . Similar findings were noted among the eight women who were studied through 12 hours . This study had a power of 87 % to detect a 20 % difference in area under the curve between the two groups . Conclusion The bioavailability of 8 mg of oral dexamethasone is similar to that of a 6-mg IM dose , as determined by the area under the curve BACKGROUND Clinical observations suggest that betamethasone reduces maternal perception of fetal movements and short term variability , but that this dose not occur after treatment with dexamethasone . OBJECTIVES To compare the effect of betamethasone and dexamethasone on fetal biophysical parameters . METHODS In a r and omized , prospect i ve , double blind study , 20 courses of betamethasone and 20 courses of dexamethasone were given in r and om sequence to patients with imminent preterm labor . During the first 32h after initiation of treatment , fetal movements were counted by the mothers and recorded by ultrasound , and a nonstress test was performed . RESULTS Betamethasone induced a significant decrease in fetal movements as perceived by the mother and observed by ultrasound . Fetal breathing movements also decreased . Dexamethasone did not change fetal body movements . Neither drug changed the short term variability . CONCLUSIONS Unlike betamethasone , dexamethasone does not induce a decrease in fetal movements .  Dexamethasone might , therefore , be preferred for enhancement of lung maturation in imminent preterm labor This study compares fetal corticoid response from conventional dose ( 12.0 mg ) intramuscular betamethasone to large dose ( 1,000 mg ) intravenous cortisol administered to women in premature labor for  acceleration of fetal lung maturity .  To compare these two regimens , 14 women selected at r and om were treated in groups of seven with either cortisol or betamethasone .  Peripheral levels of unconjugated estriol were measured by specific radioimmunoassay prior to the cortisol dose and at 1 , 4 , 8 , and 12 hours following the dose . The rate of corticoid delivery to the fetal hypothalamic-adrenal axis was estimated by the per cent suppression of unconjugated estriol at each post-treatment interval . Least-squares regression lines fitted ( P less than 0.01 ) for each regimen were compared for time saved ( delta t ) when cortisol was used . Mean delta t ( 1 , 4 , 8 , and 12 hours ) was 9.0 + /- 0.2 S.E.M. hours . It is concluded that : ( 1 ) Intravenous cortisol delivers a fetal corticoid effect that is significantly more rapid in onset and more profound in magnitude than does intramuscular betamethasone and that ( 2 ) the cortisol regimen is probably better suited to the acceleration of fetal lung maturation in premature labor when time is short and rapid action is essential Abstract Objectives To determine if antenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome alters psychological functioning and health related quality of life in adulthood . Design Follow-up of the first and largest double blind , placebo controlled , r and omised trial of a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome . Setting Tertiary obstetric hospital in Auckl and , New Zeal and . Participants 192 adult offspring , mean age 31 years , of mothers who took part in a r and omised controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome ( 87 exposed to betamethasone and 105 exposed to placebo ) . Interventions Mothers received two doses of betamethasone or placebo 24 hours apart . Main outcome measures Cognitive functioning assessed with Wechsler abbreviated scale of intelligence ; working memory and attention assessed with Benton visual retention test , paced auditory serial addition test , and Brown attention deficit disorder scale ; psychiatric morbidity assessed with Beck depression inventory II , state-trait anxiety inventory , and schizotypy traits question naire ; h and edness assessed with Edinburgh h and edness inventory ; health related quality of life assessed with short form 36 health survey . Results No differences were found between groups exposed to betamethasone and placebo in cognitive functioning , working memory and attention , psychiatric morbidity , h and edness , or health related quality of life . Conclusions Prenatal exposure to a single course of betamethasone does not alter cognitive functioning , working memory and attention , psychiatric morbidity , h and edness , or health related quality of life in adulthood . Obstetricians should continue to use a single course of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome Objective : To compare the effect of betamethasone and dexamethasone on maternal white blood cell ( WBC ) and differential count , erythrocyte sedimentation rate ( ESR ) , Apgar score , maternal and fetal plasma glucose and length of admission to delivery , gestational age at delivery in women at risk of preterm labor ( PTL ) . Study Design : Two hundred and forty pregnant women at risk for PTL with intact membranes or preterm premature rupture of the membranes ( PPROM ) were r and omly allocated to receive either two intramuscular injections of 12 mg betamethasone at 24-h intervals or 4 injections of 6 mg dexamethasone at 12-h intervals . Blood tests for WBC and differential count , ESR and fasting plasma glucose were drawn before betamethasone or dexamethasone injection and after injection every 24 h for two days . Pregnancy outcome was assessed as Apgar score , fetal plasma glucose and length of gestation . Result : In the preterm delivery group with intact membranes , no significant differences were found between the two groups in the maternal serum indicators of infection . The mean gestational age at delivery , 1- and 5-min Apgar score were higher in the dexamethasone group than in the betamethasone group . In the PPROM group , a significant rise in WBC count was occurred ( 12.4 cells/mm3 vs. 10.5 cells/mm3 , P < 0.001 ) , none of the other maternal serum indicators of infection and outcome variables showed significant differences between the dexamethasone and betamethasone groups . Conclusions : Dexamethasone compared to betamethasone significantly increased WBC count in women with PPROM , but in women at risk of PTL with intact membranes none of the maternal serum indicators of infection showed significant differences OBJECTIVES To determine the changes with postnatal age for survival , with and without major sensorineural disability , to 5 years of age in very preterm infants and to contrast their prognosis with normal birth weight ( NBW ) control participants . METHODS A geographically determined cohort study was conducted in Victoria , Australia . Consecutive live births of 23 to 27 weeks ' gestational age born during 1991 to 1992 and r and omly selected contemporaneous NBW control participants were studied . The main outcome measures were survival and rates of major disability at 5 years of age , determined for those offered intensive care , after day 7 , after day 28 , and at hospital discharge . RESULTS Of 401 live births of 23 to 27 weeks ' gestation , 225 ( 56.1 % ) survived to 5 years of age . The survival rate rose significantly with increasing gestational age at birth in those offered intensive care and by day 7 but not by day 28 . The survival rate free of major disability rose significantly with increasing gestational age at all postnatal ages but was not an independent predictive variable by day 28 ; other adverse events were more important . In the absence of adverse events , the rate of survival free of major disability for very preterm infants who had survived to discharge was 93.2 % , similar to the rate of 95.5 % for NBW control participants . CONCLUSIONS The prognosis for very preterm infants changes substantially with postnatal age . Counseling of families should be repeated at intervals , and the advice offered should vary with perinatal events OBJECTIVE The study 's objective was to compare the efficacies of oral and intramuscular antenatal administration of dexamethasone in reducing  neonatal respiratory distress syndrome .  STUDY DESIGN Subjects at high risk for preterm delivery between 24 and 33 weeks ' gestation were prospect ively r and omly assigned to receive either 6 mg intramuscular dexamethasone or 8 mg oral dexamethasone every 12 hours for 4 doses . The regimen was repeated weekly until 34 weeks ' gestation if delivery had not yet occurred . A blinded data review was performed . The primary outcome of the trial was respiratory distress syndrome . Data were analyzed in an intent to treat fashion . Comparisons were made with an unpaired t test , chi2 or Fisher exact test , and survival analysis . P < .05 was considered significant . RESULTS The study was discontinued at 39 % enrollment after a blinded review 
    Output:
    
Results for biophysical parameters were inconsistent , but mostly no clinical ly important differences were seen .
It remains unclear whether one corticosteroid ( or one particular regimen ) has advantages over another .
Dexamethasone may have some benefits compared with betamethasone such as less IVH , and a shorter length of stay in the NICU .
The intramuscular route may have advantages over the oral route for dexamethasone , as identified in one small trial .