Efficacy of Melatonin Administration in Pregnancy in Prevention of Neonatal Respiratory Distress Syndrome  in Preterm Neonates: A Randomized Controlled Trial

Fahimeh Ghotbizadeh  Vahdani; Mohammad  Haddadi; Sepideh  Ahmadi; Zahra  Panahi; Sedigheh  Hantoushzadeh; Nafiseh  Saedi; Sedigheh  Borna; Bahar  Farshidfar

doi:10.18502/jfrh.v19i3.20063

Fahimeh Ghotbizadeh Vahdani Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Haddadi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Sepideh Ahmadi Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Zahra Panahi Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Sedigheh Hantoushzadeh Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Nafiseh Saedi Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Sedigheh Borna Maternal-Fetal and Neonatal Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
Bahar Farshidfar Department of Maternal Fetal Medicine, College of Medicine, Sexual and Reproductive Health Research Center, Mazandaran University of Medical Science, Sari, Iran

DOI: https://doi.org/10.18502/jfrh.v19i3.20063

Keywords: Melatonin; Respiratory Distress Syndrome; Placenta Accreta

Abstract

Objective: Respiratory Distress Syndrome (RDA) is a common complication in premature neonates due to immature lungs, and antenatal corticosteroid administration could reduce its incidence. We aim to investigate the role of antenatal melatonin administration in preventing RDS among women with placenta accrete spectrum who usually mandate early delivery.

Materials and methods: This is a single-blinded randomized controlled trial performed in a tertiary hospital among women with placenta accrete spectrum. The melatonin group received Melatonin 10 mg/daily for two weeks before elective cesarean section in addition to corticosteroids, and the control group just received corticosteroids. The RDS occurrence was compared between two groups.

Results: In total, 60 participants were involved in the study (30 in the melatonin group and 30 in the control group). RDS was diagnosed for five (16.7%) neonates in the melatonin group and nine (30.0%) neonates in the control group (P-value= 0.228). Among neonates with RDS, no neonate in the melatonin group required intubation, and six (66.7%) neonates intubation needed in the control group (P = 0.016).

Conclusion: Antenatal melatonin administration may reduce the need for intubation in preterm neonates with RDS, though the lower incidence of RDS observed in the melatonin group was not statistically significant. The small number of RDS cases limits the ability to draw definitive conclusions regarding intubation rates and hospitalization duration. Larger-scale, multicenter studies with long-term follow-up are needed to validate these findings and better understand melatonin's role in neonatal respiratory care.