title: Behavioural, educational and respiratory outcomes of antenatal betamethasone for term caesarean section (ASTECS trial).
abstract: OBJECTIVE
  To determine whether antenatal betamethasone prior to elective term caesarean section (CS) affects long term behavioural, cognitive or developmental outcome, and whether the risk of asthma or atopic disease is reduced.
  
  
  METHODS
  A questionnaire based follow-up of a multicentre randomised controlled trial (Antenatal Steroids for Term Elective Caesarean Section, BMJ 2005).
  
  
  METHODS
  Four UK study centres from the original trial.
  
  
  METHODS
  862 participants from the four largest recruiting centres, 92% of the original study. 824 (96%) were traced and 799 (93%) were successfully contacted. Fifty-one percent (407/799) completed and returned the questionnaire. The children were aged 8-15 years (median 12.2 years, 52% girls). 386 gave consent to contact schools with 352 (91%) reports received.
  
  
  METHODS
  Questionnaires including a strengths and difficulties questionnaire, International Study of Asthma and Allergies in Childhood, general health and school performance.
  
  
  RESULTS
  There were no significant differences between children whose mothers received betamethasone and controls for the mean total strengths and difficulties questionnaire scores and subscores for hyperactivity, emotional symptoms, prosocial behaviour, conduct or peer problems. 25 (12%) children whose mothers received betamethasone had reported learning difficulties compared with 27 (14%) control children. The proportion of children who achieved standard assessment tests KS2 exams level 4 or above for mathematics, English or science was similar as were the rates of ever reported wheeze (30% vs 30%), asthma (24% vs 21%), eczema (34% vs 37%) and hay fever (25% vs 27%).
  
  
  CONCLUSIONS
  Antenatal betamethasone did not result in any adverse outcomes or reduction in asthma or atopy. It should be considered for elective CS at 37-38 weeks of gestation.
  
  
  BACKGROUND
  : Original trial was preregistration, the trial publication is BMJ. 2005 Sep 24;331(7518):662.
authors: Department of Paediatrics, Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Rhyl, Denbighshire, LL18 5UJ, UK. pstutch30@gmail.com
authors: Peter Roy
authors: PR
authors: Stutchfield
authors: Rhiannon
authors: R
authors: Whitaker
authors: Angela E
authors: AE
authors: Gliddon
authors: Lucie
authors: L
authors: Hobson
authors: Sailesh
authors: S
authors: Kotecha
authors: Iolo J M
authors: IJ
authors: Doull
mesh_terms: D000293:Adolescent; D001249:Asthma / Q000139:chemically induced* / Q000453:epidemiology; D001519:Behavior / Q000187:drug effects*; D001623:Betamethasone / Q000009:adverse effects*; D002585:Cesarean Section / Q000009:adverse effects*; D002648:Child; D003071:Cognition / Q000187:drug effects*; D004485:Eczema / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D001623:Betamethasone