Two-year follow-up of a randomised trial with repeated antenatal betamethasone.
BACKGROUND
Weekly repeated antenatal corticosteroid treatment improves respiratory outcome but decreases fetal growth and may impair neurodevelopmental outcome. We have previously reported that a single repeat betamethasone (BM) dose neither decreased fetal growth nor improved the outcome of preterm infants during the first hospitalisation.


OBJECTIVE
To study prospectively whether a single repeat dose of BM influences neurodevelopment and growth within 2 years.


METHODS
Women with imminent delivery before 34.0 gestational weeks were eligible if they remained undelivered for >7 days after a single course of antenatal BM. After stratification, a single repeat dose of BM (12 mg) or placebo was given. The children underwent neurological and psychometric examinations and a speech evaluation at a corrected age of 2 years.


METHODS
Prospective, blinded evaluation following the randomised multicentre trial.


METHODS
259 (82%) surviving infants completed the 2-year follow-up, 120 in the BM group and 139 in the placebo group.


RESULTS
The rate of survival without severe neurodevelopmental impairment was similar in both groups (BM 98%, placebo 99%). The risk of cerebral palsy (BM 2%, placebo 1%), growth or re-hospitalisation rates (BM 60%, placebo 50%) did not differ between the groups.


CONCLUSIONS
A single repeat dose of antenatal BM tended not to influence physical growth or neurodevelopment at 2 years of age.
Peltoniemi
O M
OM
Department of Paediatrics, University of Oulu, FIN-90014 University of Oulu, Finland. outi.peltoniemi@mail.suomi.net
Kari
M A
MA
Lano
A
A
Yliherva
A
A
Puosi
R
R
Lehtonen
L
L
Tammela
O
O
Hallman
M
M
D000328:Adult; D001623:Betamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000139:chemically induced*; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D008297:Male; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D047928:Premature Birth / Q000188:drug therapy; D011295:Prenatal Care / Q000379:methods; D011446:Prospective Studies; D055815:Young Adult
D005938:Glucocorticoids; D001623:Betamethasone