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Effects of antenatal dexamethasone administration in the infant: long-term follow-up
Insights
Antenatal dexamethasone therapy given to mothers before delivery showed no negative effects on infant growth or development up to three years of age. This study confirms the safety of antenatal steroids for preventing respiratory distress syndrome.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Pediatric Development
Background:
- Antenatal corticosteroid therapy is used to prevent respiratory distress syndrome (RDS) in preterm infants.
- Long-term safety and developmental outcomes of antenatal dexamethasone require thorough evaluation.
Purpose of the Study:
- To assess the efficacy and safety of antenatal dexamethasone administration.
- To evaluate infant growth, physical, motor, and neurodevelopmental outcomes up to three years of age.
Main Methods:
- Double-blind, randomized trial involving infants born to mothers receiving antenatal dexamethasone or placebo.
- Follow-up evaluations at 9, 18, and 36 months, including measurements of weight, height, head circumference, and neurodevelopmental assessments (Bayley Scales, McCarthy Scales).
Main Results:
- Slightly greater weight and height observed in the steroid group at 18 and 36 months, respectively.
- No statistically significant differences in head circumference, neurologic abnormalities, or developmental indices (MDI, PDI, GCI) between groups.
- Socioeconomic status significantly influenced developmental outcomes, but no treatment effect was observed across different demographic groups.
Conclusions:
- Antenatal dexamethasone therapy is not associated with detectable growth, physical, motor, or developmental deficiencies in children up to three years of age.
- The findings support the safety profile of antenatal dexamethasone for preventing respiratory distress syndrome.
Abstract:
Follow-up evaluations during the first 3 years of life (at 9, 18, and 36 months) were carried out in infants born to women enrolled in a double-blind, randomized trial to evaluate the efficacy and safety of antenatal dexamethasone administration for the prevention of respiratory distress syndrome. Of 739 infants born to 678 mothers, 93 (12.7%), equally distributed between placebo and steroid groups had died, and 240 (32.5%) were lost to follow-up at the end of 3 years. Weight and height at 18 and 36 months, respectively, were slightly greater in infants in the steroid group. No statistically significant differences were observed between the placebo and steroid groups with regard to head circumference and neurologic abnormalities. The Mental Development Index and the Psychomotor Development Index of the Bayley Scales at 9 and 18 months, and the General Cognitive Index or any subscales of the McCarthy Scales of Children's Abilities at 36 months also indicated comparable development within the two groups. No treatment effect was observed on developmental outcomes in boys or girls, in different racial groups, or in different socioeconomic groups. As might be expected, however, MDI, PDI and GCI were significantly influenced by socioeconomic levels. It is concluded that no detectable growth, physical, motor, or developmental deficiencies within the first 3 years of life can be attributed to antenatal dexamethasone therapy in the mothers just prior to delivery.