title: Fluorinated steroids do not improve outcome of isolated atrioventricular block.
abstract: BACKGROUND
  Congenital atrioventricular block (CAVB) is a rare disorder with a significant morbidity and mortality. Consensus regarding the prescription and efficacy of prenatal corticosteroids is lacking. This nationwide study was initiated to evaluate the effects of prenatal treatment with corticosteroids on the outcome of CAVB in The Netherlands.
  
  
  METHODS
  All fetuses identified with isolated congenital AVB-II° or AVB-III° in any of the eight academic fetal heart centers of The Netherlands between 2003 and 2013 were included and reviewed.
  
  
  RESULTS
  Fifty-six fetuses were included. Fourteen (25%) fetuses were treated with dexamethasone. We found no differences between the steroid-treated and untreated cases regarding in utero progression of the AVB (63% vs 67% respectively), survival to birth (86% vs 84%), pacemaker implantations (74% vs 58%) or long-term dilated cardiomyopathy (13% vs 17%). Steroid treated fetuses demonstrated more in utero growth restriction (38% vs 11%).
  
  
  CONCLUSIONS
  No benefit from prenatal corticosteroid treatment was demonstrated for fetuses with isolated CAVB in this study. However, we found negative side effects. Our data provide no evidence to support the routine administration of corticosteroids for the treatment of fetal CAVB.
authors.affiliation: University Medical Center Utrecht, Department of Pediatric Cardiology, Utrecht, The Netherlands; Academic Medical Center of Amsterdam, Heart Center, Department of Cardiology, Amsterdam, The Netherlands.
authors.forename: N W E
authors.initials: NW
authors.lastname: Van den Berg
authors.affiliation: University Medical Center Utrecht, Department of Pediatric Cardiology, Utrecht, The Netherlands; Radboud University Medical Center Nijmegen, Department of Pediatric Cardiology, Nijmegen, The Netherlands.
authors.forename: M G
authors.initials: MG
authors.lastname: Slieker
authors.affiliation: Erasmus University Medical Center Rotterdam, Department of Pediatric Cardiology, Rotterdam, The Netherlands.
authors.forename: I M
authors.initials: IM
authors.lastname: van Beynum
authors.affiliation: University of Groningen and University Medical Center Groningen, Department of Obstetrics and Gynecology, Groningen, The Netherlands.
authors.forename: C M
authors.initials: CM
authors.lastname: Bilardo
authors.affiliation: Radboud University Medical Center Nijmegen, Department of Obstetrics and Gynecology, Nijmegen, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: de Bruijn
authors.affiliation: Academic Medical Center of Amsterdam, Department of Pediatric Cardiology, Amsterdam, The Netherlands.
authors.forename: S A
authors.initials: SA
authors.lastname: Clur
authors.affiliation: Erasmus University Medical Center Rotterdam, Department of Obstetrics and Gynecology, Rotterdam, The Netherlands.
authors.forename: J M J
authors.initials: JM
authors.lastname: Cornette
authors.affiliation: Erasmus University Medical Center Rotterdam, Department of Pediatric Cardiology, Rotterdam, The Netherlands.
authors.forename: I M E
authors.initials: IM
authors.lastname: Frohn-Mulder
authors.affiliation: Leiden University Medical Center, Department of Obstetrics and Gynecology, Leiden, The Netherlands.
authors.forename: M C
authors.initials: MC
authors.lastname: Haak
authors.affiliation: Maastricht University Medical Center, Department of Pediatric Cardiology, Maastricht, The Netherlands.
authors.forename: K E H
authors.initials: KE
authors.lastname: van Loo-Maurus
authors.affiliation: University Medical Center Utrecht, Department of Obstetrics and Gynecology, Utrecht, The Netherlands.
authors.forename: G T R
authors.initials: GT
authors.lastname: Manten
authors.affiliation: University of Groningen and University Medical Center Groningen, Department of Pediatric Cardiology, Groningen, The Netherlands.
authors.forename: A B M H
authors.initials: AB
authors.lastname: Rackowitz
authors.affiliation: VU University Medical Center, Department of Pediatric Cardiology, Amsterdam, The Netherlands.
authors.forename: L A J
authors.initials: LA
authors.lastname: Rammeloo
authors.affiliation: Radboud University Medical Center Nijmegen, Department of Pediatric Cardiology, Nijmegen, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Reimer
authors.affiliation: Leiden University Medical Center, Department of Pediatric Cardiology, Leiden, The Netherlands.
authors.forename: M E B
authors.initials: ME
authors.lastname: Rijlaarsdam
authors.affiliation: University Medical Center Utrecht, Department of Pediatric Cardiology, Utrecht, The Netherlands; University of Oldenburg, Campus Klinikum Oldenburg, Department of Pediatric Cardiology, Oldenburg, Germany. Electronic address: freund.matthias@klinikum-oldenburg.de.
authors.forename: M W
authors.initials: MW
authors.lastname: Freund
mesh_terms: D000328:Adult; D054537:Atrioventricular Block / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005318:Fetal Heart / Q000000981:diagnostic imaging* / Q000187:drug effects*; D005500:Follow-Up Studies; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods; D011446:Prospective Studies; D013259:Steroids, Fluorinated / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D013259:Steroids, Fluorinated
keywords: Antibodies; Cardiomyopathy; Congenital atrioventricular block; Heart block