Multiple courses of antenatal corticosteroids for preterm birth study: 2-year outcomes

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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Elizabeth V Asztalos1, Kellie E Murphy, Mary E Hannah

  • 1Department of Newborn and Developmental Paediatrics, Centre for Mother, Infant, and Child Research, Sunnybrook Health Sciences Centre, M4-233 2075 Bayview Ave Toronto, Ontario, M4N 3M5, Canada. elizabeth.asztalos@sunnybrook.ca

Pediatrics
|October 20, 2010
PubMed

Insights

Repeated prenatal corticosteroid therapy courses did not alter death or neurologic impairment risks in preterm infants. Long-term follow-up is needed to assess neurobehavioral outcomes and disease susceptibility.

Area of Science:

  • Neonatal care
  • Pharmacology
  • Developmental pediatrics

Background:

  • Prenatal corticosteroid therapy is used to accelerate fetal lung maturation in preterm births.
  • The safety and efficacy of multiple courses of antenatal corticosteroids are not fully established.

Purpose of the Study:

  • To evaluate the effects of repeated prenatal corticosteroid therapy versus placebo on death or neurologic impairment in preterm infants at 18-24 months of age.

Main Methods:

  • A randomized controlled trial involving 2104 infants (1069 exposed to multiple corticosteroid courses, 1035 to placebo).
  • Primary outcome: death or neurologic impairment (cerebral palsy, cognitive delay) at 18-24 months.
  • Secondary outcomes: growth measurements (height, weight, head circumference).

Main Results:

  • No significant difference in death or neurologic impairment rates between the corticosteroid and placebo groups (13.8% vs 13.7%, P = .95).
  • Minor differences in mean weight were observed (11.94 kg vs 12.14 kg, P = .04), but height and head circumference were similar.
  • Odds ratio for death or neurologic impairment was 1.001 (95% CI: 0.75-1.30).

Conclusions:

  • Multiple courses of prenatal corticosteroids, administered every 14 days, did not increase or decrease the risk of death or neurologic impairment.
  • Further monitoring is required to assess long-term neurobehavioral function, school performance, and disease susceptibility in these children.
Abstract

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