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Childhood Pulmonary Outcomes After Late Preterm Antenatal Corticosteroids
Cynthia Gyamfi-Bannerman1, Rebecca G Clifton, Robert A Wise
1Columbia University, New York, and New York Medical College, Valhalla, New York; the University of California, San Diego, La Jolla, and Stanford University, Stanford, California; the George Washington University Biostatistics Center, Washington, DC; Johns Hopkins University, Baltimore, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; the University of Alabama at Birmingham, Birmingham, Alabama; the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; the University of Texas at Austin, Austin, the University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, and the University of Texas Medical Branch, Galveston, Texas; Brown University, Providence, Rhode Island; the University of Utah Health Sciences Center, Salt Lake City, Utah; Eastern Virginia Medical School, Norfolk, Virginia; The Ohio State University, Columbus, and MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio; the University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado; the University of North Carolina at Chapel Hill, Chapel Hill, and Duke University, Durham, North Carolina; and Northwestern University, Chicago, Illinois.
Late preterm antenatal betamethasone did not impact overall childhood respiratory impairment. However, it was linked to reduced wheezing symptoms in children aged 6 and older.
Area of Science:
- Obstetrics and Gynecology
- Pediatric Pulmonology
- Neonatal Medicine
Background:
- Antenatal corticosteroid therapy is crucial for fetal lung maturation.
- Late preterm infants (34-36 weeks gestation) may benefit from antenatal steroids.
- Potential long-term respiratory effects of antenatal steroids require evaluation.
Purpose of the Study:
- To assess the impact of antenatal betamethasone on respiratory health in children.
- To determine if late preterm steroid exposure affects childhood respiratory impairment up to age 6+.
Main Methods:
- Prospective follow-up of children from the Antenatal Late Preterm Steroids (ALPS) trial.
- Participants aged 6+ years, randomized to betamethasone or placebo.
- Primary outcome: composite of abnormal spirometry, asthma diagnosis with medication, or daily medication use.
Main Results:
- No significant difference in the primary composite respiratory outcome between betamethasone and placebo groups.
- Lower incidence of wheezing or whistling in the chest observed in the betamethasone group.
- ALPS children showed higher rates of exercise-induced wheezing compared to term controls.
Conclusions:
- Late preterm antenatal betamethasone exposure did not lead to significant differences in overall childhood respiratory impairment.
- A notable reduction in wheezing symptoms was associated with antenatal betamethasone.
- Further research is needed to understand long-term respiratory implications.
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