Outcomes at 2 years of age after repeat doses of antenatal corticosteroids

Crowther, C. A., Doyle, L. W., Haslam, R. R., Hiller, J. E., Harding, J. E., Robinson, J. S. and Gray, P. H. (2007) Outcomes at 2 years of age after repeat doses of antenatal corticosteroids. The New England Journal of Medicine, 357 12: 1179-1189. doi:10.1056/NEJMoa071152

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Author Crowther, C. A.
Doyle, L. W.
Haslam, R. R.
Hiller, J. E.
Harding, J. E.
Robinson, J. S.
Gray, P. H.
Title Outcomes at 2 years of age after repeat doses of antenatal corticosteroids
Journal name The New England Journal of Medicine   Check publisher's open access policy
ISSN 1533-4406
Publication date 2007-09-20
Year available 2007
Sub-type Article (original research)
DOI 10.1056/NEJMoa071152
Open Access Status File (Publisher version)
Volume 357
Issue 12
Start page 1179
End page 1189
Total pages 11
Editor J.M. Drazen
Place of publication Boston, MA, U.S.
Publisher Massachusetts Medical Society
Language eng
Subject CX
321019 Paediatrics
730204 Child health
11 Medical and Health Sciences
Abstract Background We previously reported the results of a randomized, controlled trial showing that repeat doses of antenatal corticosteroids reduced the risk of respiratory distress syndrome and serious neonatal morbidity. However, data have not been available regarding longer-term effects of this treatment. Methods Women who had received an initial course of corticosteroid treatment 7 or more days previously were randomly assigned to receive an intramuscular injection of corticosteroid (11.4 mg of betamethasone) or saline placebo; the dose was repeated weekly if the mother was still considered to be at risk for preterm delivery and the duration of gestation was less than 32 weeks. We assessed survival free of major neurosensory disability and body size of the children at 2 years of corrected age. Results Of the 1085 children who were alive at 2 years of age, 1047 (96.5%) were seen for assessment (521 exposed to repeat-corticosteroid treatment and 526 exposed to placebo). The rate of survival free of major disability was similar in the repeat-corticosteroid and placebo groups (84.4% and 81.0%, respectively; adjusted relative risk, 1.04, 95% confidence interval, 0.98 to 1.10; adjusted P=0.20). There were no significant differences between the groups in body size, blood pressure, use of health services, respiratory morbidity, or child behavior scores, although children exposed to repeat doses of corticosteroids were more likely than those exposed to placebo to warrant assessment for attention problems (P=0.04). Conclusions Administration of repeat doses of antenatal corticosteroids reduces neonatal morbidity without changing either survival free of major neurosensory disability or body size at 2 years of age. (Current Controlled Trials number, ISRCTN48656428).
Keyword Antenatal corticosteroids
Infant care practices
Q-Index Code CX
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
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Created: Tue, 26 May 2009, 20:09:44 EST by Denise Wilson on behalf of Medicine - Princess Alexandra Hospital