Multiple courses of antenatal corticosteroids for preterm birth study: 2-year outcomes.
OBJECTIVE
The aim of this study was to determine the effects of repeated courses of prenatal corticosteroid therapy versus placebo on death or neurologic impairment among the children enrolled in the Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study, at 18 to 24 months of age.


METHODS
A total of 2305 infants were eligible for follow-up evaluation; 2104 infants (1069 in the prenatal corticosteroid therapy group and 1035 in the placebo group) were monitored. The primary outcome was death or neurologic impairment, defined as either cerebral palsy or cognitive delay, at 18 to 24 months of age. The secondary outcomes were measurements of growth (height, weight, and head circumference).


RESULTS
Children exposed to multiple courses of prenatal corticosteroid therapy had similar rates of death or neurologic impairment, compared with children exposed to placebo (148 children [13.8%] vs 142 children [13.7%]; odds ratio: 1.001[95% confidence interval: 0.75-1.30]; P = .95). They had a mean weight of 11.94 kg, compared with 12.14 kg in the placebo group (P = .04), a mean height of 85.51 cm, compared with 85.46 cm (P = .87), and a mean head circumference of 48.18 cm, compared with 48.25 cm (P = .45).


CONCLUSIONS
Multiple courses of prenatal corticosteroid therapy, given every 14 days, did not increase or decrease the risk of death or neurologic impairment at 18 to 24 months of age, compared with a single course of prenatal corticosteroid therapy. Continued follow-up monitoring of these children is necessary to assess neurobehavioral function, school performance, and possible susceptibility to disease.
Department of Newborn and Developmental Paediatrics, Centre for Mother, Infant, and Child Research, Sunnybrook Health Sciences Centre, M4-233 2075 Bayview Ave Toronto, Ontario, M4N 3M5, Canada. elizabeth.asztalos@sunnybrook.ca
Elizabeth V
EV
Asztalos
Kellie E
KE
Murphy
Mary E
ME
Hannah
Andrew R
AR
Willan
Stephen G
SG
Matthews
Arne
A
Ohlsson
Edmond N
EN
Kelly
Saroj
S
Saigal
Susan
S
Ross
Marie-France
MF
Delisle
Kofi
K
Amankwah
Patricia
P
Guselle
Amiram
A
Gafni
Shoo K
SK
Lee
B Anthony
BA
Armson
Renee
R
Sananes
Laura
L
Tomat
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D001724:Birth Weight / Q000187:drug effects; D001827:Body Height / Q000187:drug effects; D002508:Cephalometry; D002547:Cerebral Palsy / Q000139:chemically induced* / Q000401:mortality; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008607:Intellectual Disability / Q000139:chemically induced* / Q000401:mortality; D008297:Male; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control*; D011295:Prenatal Care; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control
D000305:Adrenal Cortex Hormones