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Abstract Infants born at term by elective caesarean delivery are more likely to develop respiratory morbidity than infants born vaginally. Prophylactic corticosteroids in singleton term pregnancies accelerate lung maturation and reduce the incidence of respiratory complications (Sotiriadis et al., 2018). Antenatal betamethasone is effective in reducing admission to special care baby unit with respiratory distress after elective caesarean section at term (Stutchfield et al., 2005). The objective of this study is to assess the effect of prophylactic corticosteroid administration before elective caesarean section at term (after 37 weeks), in reducing neonatal respiratory morbidity and admission to special care units with respiratory complications. Design: Prospective randomized study. Methodology: 2 groups; (group A) which consists of 250 patients who received prophylactic corticosteroid and (Groups B) 250 patients who received placebo before elective caesarean section. The treatment group received 4 intramuscular dose of dexamethasone is 6 mg IM 12 hours apart at least 48 hours before delivery. The control group received placebo in the same manner. Outcome measures: The Primary outcome was admission to neonatal intensive care unit (NICU) with respiratory complications. Secondary outcome was severity of respiratory distress and level of care required for affected newborns. There were no significant differences between women of both groups regarding maternal outcome. Also there were no significant differences between women of both groups regarding neonatal gender, birth weight, 1-min and 5-min Apgar scores. The rate of admission to neonatal intensive care unit (NICU) for respiratory and non-respiratory cause was significantly lower in group I [Dexamethasone Group] when compared to group II [Control Group]. There was a statistically no significant difference between both groups regarding developmental RDS. There was a statistically no significant difference between both groups regarding need for mechanical ventilation. There were 3 cases of neonatal mortality in both groups with no statistical significant difference between both groups. |