Abstract
Objective: Repeat doses of antenatal corticosteroids reduce occurrence of neonatal lung disease in preterm infants. The primary objective of this study was to evaluate longer-term benefits and risks with such intervention. Here we report effects on neonatal anthropometry.
Methods: Cohort study of 94 subjects (59 boys, mean gestational age (GA) at first exposure for corticosteroids 28.7 w, GA at birth 34.0 w) born 1983-1995 and exposed to 2-9 doses of antenatal betamethasone (first 24 mg followed weekly with an additional 16 mg until delivery or 34 w GA). Exposure data were retrieved from case record files. Information on other risk factors or potential confounders (maternal age, height, parity, smoking, preeclampsia, and multiple pregnancy), and outcome was collected from the Swedish Medical Birth Registry.
Results: In univariate analyses, SD-scores for birth weight (BW), birth length (BL), and head circumference (HC) decreased from -0.25, -0.11, and +0.25 in infants exposed to 2 doses, to -0.99, -1.03, and -0.22, respectively, in infants exposed to ≥4 doses of antenatal corticosteroids (p=0.05-0.07). In multivariate analyses, ≥4 doses (n=40) was associated with lower SD-scores for BW (p=0.01), BL (p=0.007), and HC (p=0.04) as compared to SD-scores found after 2-3 doses of antenatal corticosteroids (n=54). The size of the effect from ≥4 doses of antenatal steroids on BW and BL was comparable to the reduction in birth size seen in twins, and on HC to that seen after maternal smoking.
Conclusion: Multiple doses of antenatal corticosteroids are associated with a reduction in BW, BL and HC.
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Stålnacke, J., Norberg, H., Heijtz, D. et al. 1217 Repeated Doses of Antenatal Corticosteroids for Women at Risk of Preterm Birth Reduce Size At Birth. Pediatr Res 68 (Suppl 1), 603 (2010). https://doi.org/10.1203/00006450-201011001-01217
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DOI: https://doi.org/10.1203/00006450-201011001-01217