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Multiple antenatal corticosteroids posed no increased risk for death
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Multiple courses of prenatal corticosteroid therapy taken by pregnant women did not affect the risk for death or disability in their children, according to data published in JAMA Pediatrics.
“Because of a lack of strong conclusive evidence of short-term or long-term benefits, it remains our opinion that multiple courses should not be recommended in women with ongoing risk of preterm birth,” Elizabeth V. Asztalos, MD, of The Centre for Mother, Infant and Children Research at Sunnybrook Research Institute in Toronto, and colleagues wrote. “Efforts should be made to ensure that a single course is given at the most beneficial time for the fetus rather than exposing women and their fetuses to multiple courses.”
The researchers used data from the MACS-5 study to examine the impact of single courses of antenatal corticosteroid therapies compared with multiple therapies on death or neurodevelopment disability (neuromotor, neurosensory or neurocognitive/neurobehavioral function). Other outcomes included anthropometric measures and blood pressure, intelligence, and specific cognitive (visual, spatial and language) skills, according to data.
The cohort included 1,724 women. Of the 2,141 children eligible, 1,728 (80.7%) were included in the study and data from 1,719 children were used for the primary outcomes.
In children aged 5 years, no significant differences were discovered between groups among 217 of 871 children (24.9%) in the multiple-courses group compared with 210 of 848 children (24.8%) in the single-course group (OR=1.02; 95% CI, 0.81-1.29) regarding the risk for death or neurodevelopment disability, according to data.
“Research in this area is needed to answer questions on late-presenting neurobehavioral function, neurosensory disabilities, and susceptibility to metabolic and cardiovascular disease,” Asztalos and colleagues wrote. “These outcomes may be equally, if not more, important to consider to justify a therapy such as multiple courses of antenatal corticosteroids.”
Disclosure: The researchers report no relevant financial disclosures.
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