Mid-childhood outcomes of repeat antenatal corticosteroids: a randomized controlled trial

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dc.contributor.authorCrowther, C.A.
dc.contributor.authorAnderson, P.J.
dc.contributor.authorMcKinlay, C.J.D.
dc.contributor.authorHarding, J.E.
dc.contributor.authorAshwood, P.J.
dc.contributor.authorHaslam, R.R.
dc.contributor.authorRobinson, J.S.
dc.contributor.authorDoyle, L.W.
dc.date.issued2016
dc.description.abstractOBJECTIVE: 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.
dc.description.statementofresponsibilityCaroline A. Crowther, Peter J. Anderson, Christopher J.D. McKinlay, Jane E. Harding, J. Ashwood, Ross R. Jeffery S. Robinson, Lex W. Doyle
dc.identifier.citationPediatrics, 2016; 138(4):e20160947-1-e20160947-10
dc.identifier.doi10.1542/peds.2016-0947
dc.identifier.issn0031-4005
dc.identifier.issn1098-4275
dc.identifier.orcidCrowther, C.A. [0000-0002-9079-4451]
dc.identifier.orcidAshwood, P.J. [0000-0003-4654-3281]
dc.identifier.orcidRobinson, J.S. [0000-0002-4515-6039]
dc.identifier.urihttp://hdl.handle.net/2440/102817
dc.language.isoen
dc.publisherAmerican Academy of Pediatrics
dc.rights© 2016 by the American Academy of Pediatrics.
dc.source.urihttps://doi.org/10.1542/peds.2016-0947
dc.subjectACTORDS Follow-up Group
dc.subjectHumans
dc.subjectPremature Birth
dc.subjectBetamethasone
dc.subjectGlucocorticoids
dc.subjectSpirometry
dc.subjectBody Size
dc.subjectPrenatal Care
dc.subjectDrug Administration Schedule
dc.subjectFollow-Up Studies
dc.subjectChild Behavior
dc.subjectChild Development
dc.subjectCognition
dc.subjectNeuropsychological Tests
dc.subjectPregnancy
dc.subjectBlood Pressure
dc.subjectQuality of Life
dc.subjectAdult
dc.subjectChild
dc.subjectFemale
dc.titleMid-childhood outcomes of repeat antenatal corticosteroids: a randomized controlled trial
dc.typeJournal article
pubs.publication-statusPublished

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