***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: To determine whether prenatal corticosteroid therapy would reduce the incidence of neonatal necrotizing enterocolitis ( NEC ) , we assigned a total of 466 women admitted in premature labor either to receive placebo  ( group A , n = 256 ) , if delivery was expected to occur within 24 hours of admission , or to receive betamethasone ( group B , n = 210 ) if delivery was expected to take place more than 24 hours after admission . All women were free of severe medical complications or drug therapy ; cases of intrauterine growth retardation or premature rupture of the membranes were excluded . Their newborn infants , excluding malformed , congenitally infected , and growth-retarded infants , were enrolled in the study unless they had died before the age of 10 postnatal days . Babies born to group A mothers ( n = 248 ) were further assigned to a treatment group ( group A1 , n = 130 ) receiving dexamethasone , 2 mg/kg/day by intravenous injection during the first 7 days of life , or to a control group ( group A2 , n = 118 ) receiving 10 % dextrose solution placebo .  Group B infants ( prenatal betamethasone , n = 205 ) received neither treatment nor placebo . The incidence of NEC in group A1 was 6.9 % ( 9/130 ) , and in group A2 it was 14.4 % ( 17/118 ) ( p less than 0.05 ) . In group B the incidence was 3.4 % ( 7/205 ) ; this was much lower than in group A2 ( p less than 0.01 ) and lower than in group A combined ( 10.4 % ) ( p less than 0.01 ) . There was no death from NEC and no surgical intervention among group B patients . The mortality rate for group A1 ( 11 % ) was lower than for group A2 ( 56 % ) ( p less than 0.02 ) . There were fewer indications for surgical intervention for NEC in group A1 than in group A2 . Histologic studies confirmed bowel ischemia in all specimens analyzed . These data support the hypothesis that the incidence of NEC is significantly reduced after prenatal steroid treatment . Although postnatal therapy with steroids does not decrease the incidence as effectively as prenatal therapy , it improves clinical outcome of NEC A double-blind study was design ed to investigate the effects of  antenatal glucocorticoids on the incidence of respiratory distress syndrome ( RDS ) in 128 premature human infants . There was a significant reduction ( P<0.05 ) in the incidence of RDS in the betamethasone-treated infants to 8.7 % compared to an incidence of 22.6 % in the saline-treated controls and 25.0 % in infants whose mothers received methylprednisolone . The effectiveness of betamethasone in reducing RDS was limited to premature infants delivered to mothers with intact fetal membranes and with an initial L/S ratio less than 2.0 . The time between administration of the glucocorticoid and delivery did not significantly affect the incidence of RDS in this study . The failure of methylprednisolone to reduce the development of RDS in premature infants suggests its potential use in maternal therapy during pregnancy with minimal effects on fetal maturation The objective of the series was to study the effect of prenatal dexamethasone therapy on the growth and neurological development of preterm children until the age of 2 years . Eighty‐two children with a mean gestational age of 30 ( 24–33 ) weeks and a mean weight of 1291 ( 530–2360 ) g at birth , treated antenatally with either dexamethasone ( n= 50 ) or placebo ( n= 32 ) , were examined at the adjusted age of 24 months by a paediatric neurologist , a neuropsychologist and a speech therapist . Neurological development was defined as normal if all scores of neuropaediatric , neuropsychological and verbal tests were within the normal range . Normal neurological development was found in 52 % of the dexamethasone‐treated and in 34 % of the placebo‐treated children . The incidence of cerebral palsy was 10 % in the dexamethasone group and 22 % in the placebo group . Minor developmental delay was found in 42 % of dexamethasone‐treated and in 53 % of placebo‐treated children . Our follow‐up results indicate that the beneficial effect of prenatal glucocorticoid treatment on cerebral complications I intraventricular haemorrhage or periventricular leucomalacia ) demonstrated during the neonatal period may be followed by a lower incidence of cerebral palsy in surviving premature children Objective To assess the efectiveness of corticosteroids in patients with preterm premature rupture of membranes ( PROM ) after treatment with a broad-spectrum antibiotic , ampicillin-sulbactam .  Methods A r and omized clinical trial of corticosteroids in patients with preterm PROM was undertaken after treating these patients for a minimum of 12 hours with ampicillin-sulbactam . No digital vaginal examinations were performed on these patients . Antbiotics were continued for 7 days and the steroids were repeated weekly . No tocolytics were used . The primary outcome measure was the incidence of respiratory distress syndrome ( RDS ) . Secondary outcome measures included latency period and neonatal and maternal infectious morbidity . Results Seventy-seven patients were enrolled and data about their pregnancies were analyzed . No statistically significant difference in latency period was noted ( 14.7 days in the steroid group , 15.8 days in the no-steroid group ) . Both neonatal and maternal infectious morbidity were similar . A significant reduction in the incidence of RDS ( 18.4 versus 43.6 % , P = .03 ) were observed in the steroid group . Conclusion These data suggest that treating preterm PROM patients with a broad-spectrum antibiotic before corticosteroids decreases RDS without apparent adverse sequelae BACKGROUND Infants who are born at 34 to 36 weeks of gestation ( late preterm ) are at greater risk for adverse respiratory and other outcomes than those born at 37 weeks of gestation or later . It is not known whether betamethasone administered to women at risk for late preterm delivery decreases the risks of neonatal morbidities . METHODS We conducted a multicenter , r and omized trial involving women with a singleton pregnancy at 34 weeks 0 days to 36 weeks 5 days of gestation who were at high risk for delivery during the late preterm period ( up to 36 weeks 6 days ) . The participants were assigned to receive two injections of betamethasone or matching placebo 24 hours apart . The primary outcome was a neonatal composite of treatment in the first 72 hours ( the use of continuous positive airway pressure or high-flow nasal cannula for at least 2 hours , supplemental oxygen with a fraction of inspired oxygen of at least 0.30 for at least 4 hours , extracorporeal membrane oxygenation , or mechanical ventilation ) or stillbirth or neonatal death within 72 hours after delivery . RESULTS The primary outcome occurred in 165 of 1427 infants ( 11.6 % ) in the betamethasone group and 202 of 1400 ( 14.4 % ) in the placebo group ( relative risk in the betamethasone group , 0.80 ; 95 % confidence interval [ CI ] , 0.66 to 0.97 ; P=0.02 ) . Severe respiratory complications , transient tachypnea of the newborn , surfactant use , and bronchopulmonary dysplasia also occurred significantly less frequently in the betamethasone group . There were no significant between-group differences in the incidence of chorioamnionitis or neonatal sepsis . Neonatal hypoglycemia was more common in the betamethasone group than in the placebo group ( 24.0 % vs. 15.0 % ; relative risk , 1.60 ; 95 % CI , 1.37 to 1.87 ; P<0.001 ) . CONCLUSIONS Administration of betamethasone to women at risk for late preterm delivery significantly reduced the rate of neonatal respiratory complications . ( Funded by the National Heart , Lung , and Blood Institute and the Eunice Kennedy Shriver National Institute of Child Health and Human Development ; Clinical Trials.gov number , NCT01222247 . ) Antenatal steroid therapy reduces the incidence of respiratory distress syndrome ( RDS ) in premature infants . However , animal studies showed a decrease in lung cell number and lower lung weights in fetal rabbits exposed to hydrocortisone . This prompted us to measure flows and lung volumes ( by spirometry and helium-dilution method ) in children greater than 6 years who were part of a study by the Collaborative Group on Antenatal Steroid Therapy .  The effect of antenatal steroids on subsequent pulmonary function had not previously been studied . Of the 158 children originally enrolled before birth , a total of 8 dexamethasone (DEX)- and 11 placebo-treated children were still local residents and fulfilled the criteria of the study ( gestational age , 28 - 34 weeks ; DEX/placebo treatment 1 - 7 days before delivery ) .  Mean heights and weights were normal with no significant differences between the groups . Pulmonary function tests showed no differences in lung volumes or expiratory flows between the children whose mothers had received antenatal DEX and those who had received placebo . These results indicate no adverse effect of antenatal DEX on subsequent lung volumes and expiratory flows in childhood Potential side effects of antenatal administration of corticosteroids to prevent neonatal respiratory distress syndrome were studied in 10- to 12-year-old children whose mothers had participated in a r and omized , double-blind , placebo-controlled trial of betamethasone .  The children had a general physical examination ; parents were interviewed about the medical history of their child with special attention to infectious diseases ; growth data were collected ; and a developmental neurological examination , an ophthalmological examination , and a lung function test were conducted . In the corticosteroid group significantly more hospital admissions because of infectious diseases during the first years of life were reported . On the other variables no differences between the corticoid and the placebo groups were found OBJECTIVE To study late side effects of antenatal corticosteroid treatment on health and sexual development in subjects 20 to 22 years old . METHODS A follow-up study among young adults whose mothers had , because of a threatening delivery , participated in a r and omized , double-blind , placebo- controlled trial of betamethasone to prevent neonatal respiratory distress syndrome . Measurements were taken on general health , growth , development in puberty , reproductivity , genital or gynecological complaints , gender development , sexual orientation , sex-specific cognitive functioning , and psychoneuroticism . In addition , some measurements were performed on family diseases , socioeconomic status , and education . RESULTS No differences were found between the corticosteroid-treated and placebo groups as to medical or psychological variables . In general , the subjects were healthy and had normal intellectual capacities . Groups did not differ on gender development , sexual orientation , sex-specific cognitive functioning , and psychoneuroticism . Systolic blood pressure was significantly lower in the corticosteroid group , but the groups did not differ as to diastolic blood pressure . CONCLUSIONS Our 20-year follow-up study indicates that 1 course of antenatally administered corticosteroid to prevent respiratory distress syndrome does not have adverse effects up to adulthood A prospect i ve double-blind r and omized clinical trial was carried out to determine whether glucocorticoid treatment reduces the risk of respiratory distress syndrome ( RDS ) in prematurely born infants . There were 127 infants born to 122 mothers who received either steroid ( dexamethasone phosphate ) or placebo .  No differences between groups occurred in risk factors for RDS ( eg , prepartum asphyxia , male sex , cesarean section ) . When those who received a full course of dexamethasone therapy were compared with those who received placebo , a significant reduction was found in risk , severity , and deaths due to RDS . An increased incidence of infection in mothers treated with steroid was evident , particularly after premature rupture of membranes . We conclude that steroids are effective in reducing risk of RDS , but safer and more efficacious approaches for the prevention of RDS should be sought In a large multicentered , collaborative r and omized and blinded trial utilizing antenatal corticosteroids , the goals included determining the effectiveness of these agents in accelerating lung maturation , as well as monitoring any short-term or long-term adverse effects of this treatment on the parturient , fetus , and /or infant . More than 100 specific items , pertaining to diagnoses , complications , and outcomes were recorded for the 696 mothers enrolled in the study and their 745 infants . A significantly decreased incidence of necrotizing enterocolitis ( P = .002 ) was found in the infants treated with steroids . The possibility of accelerated intestinal maturation induced by antenatal maternal steroid therapy exists . This treatment regimen is particularly attractive as adverse aspects of steroid therapy at the dosage utilized have not been demonstrated In a prospect i ve , r and omized , double‐blind , multicentre trial the effect of antenatal treatment with betamethasone phosphate was compared with placebo in the prevention of 
    Output:
    
No increased risk in maternal death was observed .
Evidence from this up date supports the continued use of a single course of antenatal corticosteroids to accelerate fetal lung maturation in women at risk of preterm birth .
A single course of antenatal corticosteroids could be considered routine for preterm delivery .