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Type: Journal article
Title: Mid-childhood outcomes of repeat antenatal corticosteroids: a randomized controlled trial
Author: Crowther, C.A.
Anderson, P.J.
McKinlay, C.J.D.
Harding, J.E.
Ashwood, P.J.
Haslam, R.R.
Robinson, J.S.
Doyle, L.W.
Citation: Pediatrics, 2016; 138(4):e20160947-1-e20160947-10
Publisher: American Academy of Pediatrics
Issue Date: 2016
ISSN: 0031-4005
Statement of
Caroline A. Crowther, Peter J. Anderson, Christopher J.D. McKinlay, Jane E. Harding, J. Ashwood, Ross R. Jeffery S. Robinson, Lex W. Doyle
Abstract: OBJECTIVE: To assess if exposure to repeat dose(s) of antenatal corticosteroids has beneficial abstract effects on neurodevelopment and general health in mid-childhood, at 6 to 8 years’ corrected age. METHODS: Women at risk for very preterm birth, who had received a course of corticosteroids ≥7 days previously, were randomized to intramuscular betamethasone (11.4 mg Celestone Chronodose) or saline placebo, repeated weekly if risk of very preterm birth remained. Midchildhood assessments included neurocognitive function, behavior, growth, lung function, blood pressure, health-related quality of life, and health service utilization. The primary outcome was survival free of neurosensory disability. RESULTS: Of the 1059 eligible long-term survivors, 963 (91%) were included in the primary outcome; 479 (91%) in the repeat corticosteroid group and 484 (91%) in the placebo group. The rate of survival free of neurosensory disability was similar in both groups (78.3% repeat versus 77.3% placebo; risk ratio 1.00, 95% confidence interval, 0.94–1.08). Neurodevelopment, including cognitive function, and behavior, body size, blood pressure, spirometry, and health-related quality of life were similar in both groups, as was the use of health services. CONCLUSIONS: Treatment with repeat dose(s) of antenatal corticosteroids was associated with neither benefit nor harm in mid-childhood. Our finding of long-term safety supports the use of repeat dose(s) of antenatal corticosteroids, in view of the related neonatal benefits. For women at risk for preterm birth before 32 weeks’ gestation, ≥7 days after an initial course of antenatal corticosteroids, clinicians could consider using a single injection of betamethasone, repeated weekly if risk remains.
Keywords: ACTORDS Follow-up Group
Premature Birth
Body Size
Prenatal Care
Drug Administration Schedule
Follow-Up Studies
Child Behavior
Child Development
Neuropsychological Tests
Blood Pressure
Quality of Life
Rights: © 2016 by the American Academy of Pediatrics.
DOI: 10.1542/peds.2016-0947
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