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Repeated antenatal corticosteroids: effects on cerebral palsy and childhood behavior

Noel P French1, Ronald Hagan, Sharon F Evans

  • 1Department of Neonatal Paediatrics, King Edward Memorial Hospital, Subiaco, Perth, Australia. Noel.French@health.wa.gov.au

American Journal of Obstetrics and Gynecology
|March 26, 2004
PubMed

Insights

Repeated antenatal corticosteroid courses may reduce cerebral palsy risk in preterm infants. However, multiple courses are linked to increased hyperactivity and behavioral issues later in childhood.

Area of Science:

  • Neonatal research
  • Pediatric neurology
  • Developmental pediatrics

Background:

  • Antenatal corticosteroids are used to mature fetal lungs in preterm births.
  • The long-term effects of repeated courses on neurodevelopment are not fully understood.

Purpose of the Study:

  • To investigate the impact of repeated antenatal corticosteroid courses on childhood behavior and disabilities.
  • To assess effects on cognitive delay and cerebral palsy in very preterm infants.

Main Methods:

  • A nonrandomized cohort study of 541 very preterm infants born in Western Australia.
  • Infants were assessed physically, cognitively, and psychologically up to 6 years of age.

Main Results:

  • More antenatal corticosteroid courses correlated with a lower incidence of cerebral palsy.
  • Three or more courses were associated with higher rates of aggressive, distractible, and hyperkinetic behaviors at ages 3 and 6.
  • No significant effects were observed on internalizing behaviors or intelligence quotient.

Conclusions:

  • Repeated antenatal corticosteroid administration may offer protection against cerebral palsy.
  • However, it is associated with an increased risk of hyperactivity and behavioral problems in later childhood.
Abstract

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