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Death risk similar with multiple, single courses of antenatal corticosteroids
Multiple courses and single courses of antenatal corticosteroids for women who are at risk for preterm birth do not increase or decrease risk for death or disability for their children at age 5 years, according to recent study findings 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,” the researchers wrote.
The Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS) included 1,724 women and 1,728 children to discover the effect of single and multiple courses of antenatal corticosteroid therapy on the death or neurodevelopmental disability at age 5 years. The primary outcome of the study included death and neurodevelopmental disability, including one of the following: neuromotor (nonambulatory cerebral palsy), neurosensory (blindness, deafness, or need for visual/hearing aids), or neurocognitive/neurobehavioral function (abnormal attention, memory, or behavior).
Researchers found no significant difference between multiple or single courses of antenatal corticosteroids in risk for death or neurodevelopmental disability (OR=1.02; 95% CI, 0.81-1.29).
“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 wrote. “The possibility of ongoing long-term harm needs further evaluation. Research in this area is needed to answer questions on late-presenting neurobehavioral function, neurosensory disabilities, and susceptibility to metabolic and cardiovascular disease. These outcomes may be equally, if not more, important to consider to justify a therapy such as multiple courses of antenatal corticosteroids.”
Disclosure: The study was funded in part by the Canadian Institutes of Health Research.
