Neurodevelopmental outcome of very low birth weight infants after multiple courses of antenatal corticosteroids.
OBJECTIVE
To determine if two or more courses of antenatal corticosteroids are associated with neurodevelopmental impairment.


METHODS
All infants born at Northwestern Memorial Hospital between 1995 and 1998, who met the following criteria, were identified: birth weight < or = 1500 g, gestational age between 24 and 34 weeks, recipient of antenatal corticosteroids, and subsequent neurodevelopmental evaluation in multidisciplinary developmental evaluation clinic. The outcomes of these infants were compared according to degree of corticosteroid exposure. This study had 80% power to detect a difference in the mental development index score of 10% or a relative risk of neurodevelopmental delay of 2.5 in the group receiving at least two courses of corticosteroids.


RESULTS
Ninety-three infants were exposed to less than two full courses and 33 infants were exposed to at least two full courses of corticosteroids. The mean duration of follow-up was similar in the two groups (25 months vs 30 months, respectively, P >.05). The two groups had similar neonatal outcomes, and had no differences in any measures of neurodevelopmental outcome on follow-up.


CONCLUSIONS
Repeated courses of antenatal corticosteroids are not associated with increased incidence of abnormalities on subsequent neurodevelopmental outcome measures.
Kumar
Praveen
P
Departments of Pediatrics and Maternal-Fetal Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA. p-kumar@northwestern.edu
Seshadri
Roopa
R
Grobman
William A
WA
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight / Q000502:physiology*; D008297:Male; D009420:Nervous System / Q000254:growth & development*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects
D000305:Adrenal Cortex Hormones