Balancing act: Medical decisions, costs, and infant health in pregnancy

Late-Preterm Betamethasone: Is This Common Pregnancy Practice Really Worth It?

Theo Raines in Health & Wellness December 2025 • 4 min read.

"A closer look at the cost-effectiveness of antenatal corticosteroids in late-preterm pregnancies reveals surprising insights for expectant mothers."

For expectant parents navigating the complexities of pregnancy, especially when facing a late-preterm delivery (between 34 and 36 weeks gestation), decisions about medical interventions can feel overwhelming. One such intervention is the administration of antenatal corticosteroids, like betamethasone, aimed at improving neonatal respiratory outcomes. While this practice has become increasingly common, a critical question remains: Is it truly cost-effective?

A recent study published in The Journal of Maternal-Fetal & Neonatal Medicine sheds light on this very question, offering a detailed cost-effectiveness analysis of betamethasone administration in late-preterm gestations. The findings might surprise you, challenging the assumption that this standard of care always provides the best value.

This article breaks down the study's methodology, results, and implications, empowering you with the knowledge to have informed conversations with your healthcare providers and make the best decisions for your unique situation. We'll explore the potential benefits and risks, offering a balanced perspective grounded in evidence-based research.

The Core Question: Does Betamethasone Really Save Money and Improve Outcomes?

Balancing act: Medical decisions, costs, and infant health in pregnancy

The study employed a cost-effectiveness analysis, a method used to compare the costs of a medical intervention with its benefits. Researchers built a model using data from the 'Antenatal Betamethasone for Women at Risk for Late Preterm Delivery' (ALPS) trial and other sources to simulate the outcomes and costs associated with betamethasone administration versus no administration in late-preterm pregnancies.

They looked at several key factors, including:

Neonatal outcomes: Respiratory distress syndrome (RDS), transient tachypnea of the newborn (TTN), and hypoglycemia (low blood sugar)
Healthcare costs: Hospital costs associated with these outcomes, as well as the cost of betamethasone itself.
Quality-adjusted life years (QALYs): A measure that combines both the length and quality of life, allowing researchers to assess the overall health benefit of each intervention.

The model then calculated the incremental cost-effectiveness ratio (ICER), which represents the additional cost per QALY gained with betamethasone administration. This helps determine whether the benefits justify the costs.

Empowering Informed Decisions for Expectant Parents

Ultimately, the decision of whether or not to administer betamethasone in a late-preterm pregnancy is a complex one that should be made in consultation with your healthcare provider. This study provides valuable information to inform that conversation, highlighting the potential trade-offs between costs and benefits. By understanding the nuances of this intervention, you can advocate for the best possible care and ensure a healthy start for your little one.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1080/14767058.2018.1540582, Alternate LINK

Title: Antenatal Corticosteroid Administration In Late-Preterm Gestations: A Cost-Effectiveness Analysis

Subject: Obstetrics and Gynecology

Journal: The Journal of Maternal-Fetal & Neonatal Medicine

Publisher: Informa UK Limited

Authors: Joshua I. Rosenbloom, Adam K. Lewkowitz, Kristina E. Sondgeroth, Jessica L. Hudson, George A. Macones, Alison G. Cahill, Methodius G. Tuuli, Su-Hsin Chang

Published: 2018-11-15

Everything You Need To Know

What is betamethasone and why is it used in late-preterm pregnancies?

Betamethasone is an antenatal corticosteroid administered to expectant mothers facing late-preterm delivery, typically between 34 and 36 weeks of gestation. Its primary purpose is to improve neonatal respiratory outcomes by accelerating lung maturity in the baby. This can help reduce the risk of conditions like Respiratory Distress Syndrome (RDS).

What is a cost-effectiveness analysis and how was it applied to betamethasone administration in late-preterm pregnancies?

A cost-effectiveness analysis is a method used to compare the costs of a medical intervention with its benefits. In the context of betamethasone administration, researchers built a model using data from the 'Antenatal Betamethasone for Women at Risk for Late Preterm Delivery' (ALPS) trial to simulate the outcomes and costs associated with betamethasone administration versus no administration. This involved assessing neonatal outcomes like Respiratory Distress Syndrome (RDS), Transient Tachypnea of the Newborn (TTN), and hypoglycemia, as well as healthcare costs and quality-adjusted life years (QALYs). The model then calculated the incremental cost-effectiveness ratio (ICER) to determine if the benefits justify the costs.

What key factors were considered in the cost-effectiveness analysis of betamethasone?

The analysis considered several key factors including neonatal outcomes such as Respiratory Distress Syndrome (RDS), Transient Tachypnea of the Newborn (TTN), and hypoglycemia. Healthcare costs associated with these outcomes, including hospital costs and the cost of betamethasone itself, were also evaluated. Furthermore, the analysis incorporated quality-adjusted life years (QALYs), a measure that combines both the length and quality of life, to assess the overall health benefit of betamethasone administration.

What are Quality-Adjusted Life Years (QALYs), and why are they important in evaluating medical interventions like betamethasone?

Quality-Adjusted Life Years (QALYs) are a measure that combines both the length and quality of life into a single metric. They are used to assess the overall health benefit of a medical intervention. In the context of betamethasone administration, QALYs help determine whether the improvements in neonatal outcomes, such as reduced Respiratory Distress Syndrome (RDS), translate into a significant improvement in the baby's overall health and well-being over their lifetime. By considering both the length and quality of life, QALYs provide a more comprehensive assessment of the value of betamethasone compared to simply looking at cost or survival rates alone. This is important to understanding the overall impact.

Besides the ALPS trial, what other information should expectant parents consider when deciding about betamethasone?

Beyond the 'Antenatal Betamethasone for Women at Risk for Late Preterm Delivery' (ALPS) trial, expectant parents should discuss their individual risk factors and medical history with their healthcare provider. It's important to consider potential side effects, both for the mother and the baby, as well as the potential long-term implications of betamethasone exposure. Understanding the specific context of the pregnancy, including any existing health conditions or risk factors for preterm labor, is crucial for making an informed decision. Discussing alternative strategies and monitoring protocols can provide a more complete picture.