title: Cardiovascular risk factors in children after repeat doses of antenatal glucocorticoids: an RCT.
abstract: BACKGROUND
  Treatment of women at risk for preterm birth with repeat doses of glucocorticoids reduces neonatal morbidity but could have adverse long-term effects on cardiometabolic health in offspring. We assessed whether exposure to repeat antenatal betamethasone increased risk factors for later cardiometabolic disease in children whose mothers participated in the Australasian Collaborative Trial of Repeat Doses of Corticosteroids.
  
  
  METHODS
  Women were randomized to betamethasone or placebo treatment, ≥ 7 days after an initial course of glucocorticoids, repeated each week that they remained at risk for preterm birth at <32 weeks' gestation. In this follow-up study, children were assessed at 6 to 8 years' corrected age for body composition, insulin sensitivity, ambulatory blood pressure, and renal function.
  
  
  RESULTS
  Of 320 eligible childhood survivors, 258 were studied (81%; 123 repeat betamethasone group; 135 placebo [single course] group). Children exposed to repeat antenatal betamethasone and those exposed to placebo had similar total fat mass (geometric mean ratio 0.98, 95% confidence interval [CI] 0.78 to 1.23), minimal model insulin sensitivity (geometric mean ratio 0.89, 95% CI 0.74 to 1.08), 24-hour ambulatory blood pressure (mean difference systolic 0 mm Hg, 95% CI -2 to 2; diastolic 0 mm Hg, 95% CI -1 to 1), and estimated glomerular filtration rate (mean difference 1.2 mL/min/1.73 m(2), 95% CI -3.2 to 5.6).
  
  
  CONCLUSIONS
  Exposure to repeat doses of antenatal betamethasone compared with a single course of glucocorticoids does not increase risk factors for cardiometabolic disease at early school age.
authors.affiliation: Liggins Institute, The University of Auckland, Auckland, New Zealand;
authors.forename: Christopher J D
authors.initials: CJ
authors.lastname: McKinlay
authors.affiliation: Liggins Institute, The University of Auckland, Auckland, New Zealand;
authors.forename: Wayne S
authors.initials: WS
authors.lastname: Cutfield
authors.affiliation: Newborn Services, National Women's Health, Auckland City Hospital, Auckland, New Zealand;
authors.forename: Malcolm R
authors.initials: MR
authors.lastname: Battin
authors.affiliation: Children's Emergency Department, Starship Children's Health, Auckland, New Zealand; and.
authors.forename: Stuart R
authors.initials: SR
authors.lastname: Dalziel
authors.affiliation: Liggins Institute, The University of Auckland, Auckland, New Zealand; Australian Research Centre for Health of Women and Babies, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, Australia.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Crowther
authors.affiliation: Liggins Institute, The University of Auckland, Auckland, New Zealand; j.harding@auckland.ac.nz.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Harding
mesh_terms: D000273:Adipose Tissue / Q000187:drug effects; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D001794:Blood Pressure / Q000187:drug effects; D002318:Cardiovascular Diseases / Q000139:chemically induced*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D007273:Injections, Intramuscular; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors
chemical_list: C028994:betamethasone sodium phosphate; D001623:Betamethasone; C580789:betamethasone acetate
keywords: glucocorticoids; premature birth