Cost-effectiveness of betamethasone therapy for women at risk of delivering a premature baby (between 34 and 36 weeks)

Premature babies often have numerous health problems, and require extensive, costly treatments (1). Their underdeveloped organs and general fragility make them especially susceptible to birth injuries, infections, and other neonatal complications.

In the United States, 70% of premature births occur between weeks 34 and 36 of pregnancy, or the “late preterm period” (2) These infants often have respiratory issues, such as respiratory distress syndrome (RDS), transient tachypnea of the newborn, and a need for ventilator and surfactant use (3).

If a woman is at high risk of a late preterm delivery, doctors can administer an antenatal corticosteroid called betamethasone in order to accelerate fetal lung maturity and prepare the baby for life outside the womb. Previous research has shown this to be an effective therapy; it reduces the rate of short-term neonatal complications (4), dramatically increases survival rates (5), and also reduces the risk of lifelong disabilities such as cerebral palsy (CP) (6). However, until recently, the impact of betamethasone therapy on overall treatment costs was not known.

Gyamfi-Bannerman and colleagues from the Eunice Kennedy Shriver National Institute of Child Health and Human Development recently evaluated the cost-effectiveness of betamethasone (1).


Gyamfi-Bannerman et al. conducted a secondary analysis of data from the Antenatal Late Preterm Steroids trial, which examined the impacts of antenatal corticosteroids vs. a placebo in women at risk for late preterm delivery. They included maternal costs (based on Medicaid rates) as well as all direct medical costs for newborn care.


The authors found that treatment with betamethasone in the late preterm period significantly reduced the overall costs of care needed. Woman-infant pairs in the placebo group required a mean of $5,379 worth of care, while those who received betamethasone only required $4,681 on average. It is important to stress that cost effectiveness was also associated with improved outcomes; essentially, betamethasone therapy saves both money and lives.

Want to learn more about betamethasone therapy?

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About ABC Law Centers

ABC Law Centers was established to focus exclusively on birth injury cases. A “birth injury” is any type of harm to a baby that occurs just before, during, or after birth. This includes issues such as hypoxic-ischemic encephalopathy (HIE), infection, and trauma. While some children with birth injuries make a complete recovery, others develop disabilities such as cerebral palsy and epilepsy.

If a birth injury/subsequent disability could have been prevented with proper care, then it constitutes medical malpractice. Settlements from birth injury cases can cover the costs of lifelong treatment, care, and other crucial resources.

If you believe you may have a birth injury case for your child, please contact us today to learn more. We are happy to talk to you free of any obligation or charge. In fact, clients pay nothing throughout the entire legal process unless we win.

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  1. Hibbard JU, Wilkins I, Sun L, et al; Consortium on Safe Labor. Respiratory morbidity in late preterm births. JAMA. 2010;304(4):419-425. doi:10.1001/ jama.2010.1015
  2. Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ. Births: final data for 2015. Natl Vital Stat Rep. 2017;66(1):1.
  3. Gyamfi-Bannerman C, Zupancic JAF, Sandoval G, et al. Cost-effectiveness of Antenatal Corticosteroid Therapy vs No Therapy in Women at Risk of Late Preterm Delivery: A Secondary Analysis of a Randomized Clinical Trial. JAMA Pediatr. Published online March 11, 2019. doi:10.1001/jamapediatrics.2019.0032
  4. Gyamfi-Bannerman C, Thom EA, Blackwell SC, et al; NICHD Maternal–Fetal Medicine Units Network. Antenatal betamethasone for women at risk for late preterm delivery. N Engl J Med. 2016; 374(14):1311-1320. doi:10.1056/NEJMoa1516783
  5. Treatment of Preterm Labor: Steroids and Antibiotics. (2019). Retrieved from
  6. O’Shea, T. M., Jacks, K. E., Klinepeter, K. L., Peters, N. J., & Dillard, R. G. (1999). Antenatal Betamethasone and the Risk of Cerebral Palsy (CP) in Very Low Birth Weight (VLBW) Neonates. Pediatric Research, 45(4, Part 2 of 2), 252A.