Euglycemia protocol after antenatal betamethasone aims to reduce fetal hyperinsulinemia in late preterm neonates

Annually, 300,000 neonates are born late preterm (34 weeks 0 days - 36 weeks 6 days) in the U.S. The original Antenatal Late Preterm Steroids (ALPS) Trial demonstrated that maternal treatment with betamethasone significantly reduces severe neonatal respiratory complications. However, a critical drawback was a concurrent increase in neonatal hypoglycemia. This new study addresses this gap by exploring whether a targeted management protocol can mitigate the adverse metabolic effects of betamethasone on the fetus.

The E-ALPS study outlines a research protocol designed to evaluate a novel management strategy for pregnant women receiving Antenatal Late Preterm Steroids (ALPS). This protocol specifically aims at maintaining maternal euglycemia after betamethasone administration. The study's primary objective is to determine if this euglycemia-focused management can decrease fetal hyperinsulinemia, compared to usual antepartum care. The design implies a randomized comparison, with one arm receiving the euglycemia protocol and the control arm receiving routine prenatal care, similar to the original ALPS trial's control group.