Abstract 1435 Poster Session III, Monday, 5/3 (poster 30)

Introduction-The Australian collaborative trial on antenatal thyrotrophin-releasing hormone(TRH) and glucocorticoid reported detrimental effects at 12 month follow-up of infants treated with TRH. TRH was associated to an increase risk for motor, social, fine motor delay, sensory and early language impairment. Following these findings, we evaluated physical status and neurodevelopmental outcome at 20±4 months of infants who had received either antenatal glucocorticoid combined with intraamniotic thyroxine versus steroids alone.Method- Forty-five infants (without mayor anomalies) were assessed at follow up. Patients were assigned to a double-blind randomized controlled trial using the two drug regimen. Infants were evaluated by a pediatrician and a pediatric psychologist. Neurodevelopmental assessment was performed utilizing the Bayley Scales of Infant Developmental and the Child Behavior Checklist. Other variables studied included growth parameters (weight, height, and head circumference) as well as information related to medical complications (hospitalization, infection, surgery, and respiratory problems). Sociodemographic status was evaluated with the Hollishead scale. Qualitative ANOVA and Wilcoxon rank test were used for analysis. Logistic regression was used to determine the relation between treatment, neurodevelopmental assessment, and medical complications. Results There was no statistical difference in growth parameters, medical complications or neurodevelopmental outcome between the two treatment groups. Socioeconomic status, an important correlate of child cognitive/language functioning, was not significantly different among the groups. Particular interest was the lower mean Bayley Developmental scores in both treatment groups. (Table) (MDI=Mental Developmental Index, PDI=Psychological Developmental Index, CDA=Cognitive Developmental Age, LDA=Language Developmental Age). Conclusions-The preliminary data revealed no significant differences in the neurodevelopmental outcome of the two groups at 20 months age; however of concern is the overall lower Bayley score of the two treatment groups. Further studies need to address this issue. (Funded by RCM-Clinical Research Center)

Table 1 No caption available
Full size table