Does antenatal corticosteroid therapy affect birth weight and head circumference?
OBJECTIVE
To determine whether antenatal corticosteroid use is associated with weight and head circumference at birth.


METHODS
We conducted a retrospective analysis of nonanomalous newborns admitted to 100 neonatal intensive care units from 23 to 34 6/7 weeks of gestation using multivariable analysis of variance that controlled for several potentially confounding variables.


RESULTS
There were 14,338 cases of birth weight and 13,670 for head circumference available for analysis. Independent variables included maternal age, race, nulliparity, poor prenatal care, multiple gestation, obstetric complications, alcohol, smoking, illicit drugs, presentation, gestational age at birth, and method of delivery. The mean (+/-SD) birth weight was 1671 +/- 574 g and head circumference was 289 +/- 33 mm. The multivariable effect of antenatal corticosteroid on birth weight (mean +/- SE) was -63 +/- 5.7 g and on head circumference was -3.1 +/- 0.4 mm. Even after controlling for birth weight, a significant reduction in head circumference (-1.2 +/- 0.3 mm; 95% CI = -1.8, -0.6) was associated with antenatal corticosteroid use. This suggested that antenatal corticosteroids were associated with a greater reduction in brain growth than somatic growth.


CONCLUSIONS
Antenatal corticosteroid may be associated with a reduction in birth weight and head circumference, independent of other major predictive factors. The reduction in head circumference persists even after controlling for the reduction in birth weight. The clinical significance of these findings is unknown.
Thorp
James A
JA
Regional Perinatal Center, Sacred Heart Women's Hospital, Pensacola, Florida, USA. jathorp@bellsouth.net
Jones
Philip G
PG
Knox
Eric
E
Clark
Reese H
RH
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D000328:Adult; D000704:Analysis of Variance; D001724:Birth Weight; D001921:Brain / Q000187:drug effects / Q000254:growth & development*; D002508:Cephalometry; D016001:Confidence Intervals; D005260:Female; D005865:Gestational Age; D006257:Head / Q000033:anatomy & histology*; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D015999:Multivariate Analysis; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors
D000305:Adrenal Cortex Hormones