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The benefits of dexamethasone or betamethasone administration in pregnant women at risk for preterm birth are well known in high-resource countries — but what about in low-resource countries? Researchers randomized 2852 pregnant women at risk for preterm birth in Bangladesh, India, Kenya, Nigeria, and Pakistan to dexamethasone (6 mg intramuscularly every 12 hours for at most 4 doses) or placebo injections. A repeat course could be given if the woman had not delivered within 7 days. Mean gestational age at trial entry was approximately 31 weeks. About 70% of participants delivered within 1 week of entry.
Neonatal death occurred less often with dexamethasone than with placebo (19.6% vs. 23.5%; relative risk, 0.84); similarly, likelihood of sti…