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Published on: August 25, 2014
Long-term physical and neurodevelopmental outcomes after antenatal betamethasone administration for congenital heart
Yuka Sano Wada1, Ikuko Hama1, Mikako Goto2
1Division of Neonatology, Center for Maternal-Fetal, Neonatal, and Reproductive Medicine, National Center for Child Health and Development, Tokyo, Japan.
Insights
Antenatal betamethasone is a steroid treatment for congenital heart block (CHB). This study found no negative long-term effects on children's growth or neurodevelopment.
Area of Science:
- Maternal-fetal medicine
- Pediatric cardiology
- Neonatology
Background:
- Congenital heart block (CHB) presents significant mortality and morbidity risks.
- Antenatal steroid therapy, like betamethasone, may prevent CHB but carries potential risks.
- Long-term impacts of antenatal betamethasone on child development require further investigation.
Purpose of the Study:
- To evaluate the long-term physical growth and neurodevelopmental outcomes in children exposed to antenatal betamethasone.
- To assess the safety profile of antenatal betamethasone in a high-risk CHB population.
Main Methods:
- Children at high risk for CHB received antenatal betamethasone.
- Physical outcomes (weight, height, blood pressure) were monitored.
- Neurodevelopmental assessments included cognitive, developmental, and autism spectrum evaluations.
Main Results:
- Fourteen children were included in the study.
- All participants exhibited normal physical growth parameters (weight and height).
- Comprehensive neurodevelopmental assessments revealed normal intelligence and no autism diagnoses.
Conclusions:
- Antenatal betamethasone administration appears safe regarding long-term physical development.
- The study suggests no adverse neurodevelopmental effects associated with antenatal betamethasone exposure.
- Further research with larger cohorts may solidify these findings on antenatal steroid safety.
Introduction:
Congenital heart block (CHB) is associated with a mortality rate of 20% and requires a pacemaker in 70% of cases. Steroids can reduce morbidity and prevent the onset of CHB but may have adverse effects on growth and neurodevelopment. This study aimed to clarify the long-term effects of antenatal betamethasone administration on growth and neurodevelopment.
Methods:
The subjects were children with a high risk of CHB due to a high level of maternal anti-SSA/Ro antibody or a maternal history of a previous delivery of a offspring with CHB to whom antenatal betamethasone was administered. Data on body weight, height, and blood pressure were collected as physical outcomes. The Wechsler Intelligence Scale for Children (fourth edition) or the Kyoto Scale of Psychological Development and the Pervasive Developmental Disorders Autism Society Japan Rating Scale was administered to assess the neurodevelopmental outcome.
Results:
Fourteen children were enrolled. The body weight and height were within normal range in all children. All children had normal intelligence, and none had autism.
Conclusion:
Our study suggested that antenatal betamethasone administration has no negative effects on long-term physical and neurodevelopmental outcomes.
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