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Type: Journal article
Title: Outcomes at 2 years of age after repeat doses of antenatal corticosteroids
Author: Crowther, C.
Doyle, L.
Haslam, R.
Hiller, J.
Harding, J.
Robinson, J.
Citation: New England Journal of Medicine, 2007; 357(12):1179-1189
Publisher: Massachusetts Medical Soc
Issue Date: 2007
ISSN: 0028-4793
Organisation: ACTORDS Study Group
Statement of
Caroline A. Crowther, Lex W. Doyle, Ross R. Haslam, Janet E. Hiller, Jane E. Harding, Jeffrey S. Robinson, for the ACTORDS Study Group
Abstract: Background We previously reported the results of a randomized, controlled trial showing that repeat doses of antenatal corticosteroids reduced the risk of respiratory distress syndrome and serious neonatal morbidity. However, data have not been available regarding longer-term effects of this treatment. Methods Women who had received an initial course of corticosteroid treatment 7 or more days previously were randomly assigned to receive an intramuscular injection of corticosteroid (11.4 mg of betamethasone) or saline placebo; the dose was repeated weekly if the mother was still considered to be at risk for preterm delivery and the duration of gestation was less than 32 weeks. We assessed survival free of major neurosensory disability and body size of the children at 2 years of corrected age. Results Of the 1085 children who were alive at 2 years of age, 1047 (96.5%) were seen for assessment (521 exposed to repeat-corticosteroid treatment and 526 exposed to placebo). The rate of survival free of major disability was similar in the repeat-corticosteroid and placebo groups (84.4% and 81.0%, respectively; adjusted relative risk, 1.04, 95% confidence interval, 0.98 to 1.10; adjusted P=0.20). There were no significant differences between the groups in body size, blood pressure, use of health services, respiratory morbidity, or child behavior scores, although children exposed to repeat doses of corticosteroids were more likely than those exposed to placebo to warrant assessment for attention problems (P=0.04). Conclusions Administration of repeat doses of antenatal corticosteroids reduces neonatal morbidity without changing either survival free of major neurosensory disability or body size at 2 years of age. (Current Controlled Trials number, ISRCTN48656428 [] .)
Keywords: ACTORDS Study Group
Cerebral Palsy
Body Size
Prenatal Care
Follow-Up Studies
Child Behavior Disorders
Developmental Disabilities
Health Status
Child, Preschool
Description: © 2008 Massachusetts Medical Society. All rights reserved.
DOI: 10.1056/NEJMoa071152
Appears in Collections:Aurora harvest
Obstetrics and Gynaecology publications

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