Study: steroids and preterm birth
There are no additional health benefits for preterm babies whose mothers received multiple courses of corticosteroids before giving birth, even five years later, a new Sunnybrook-led study has found.
"Corticosteroids are administered to women at risk of giving birth to their babies preterm, between 24 and 33 weeks gestation, as it can enhance lung maturity in preterm babies. However, the long-term effects on babies whose mothers received corticosteroids multiple times, as opposed to once, were not clear," says principle investigator Dr. Elizabeth Asztalos, staff neonatologist, Department of Newborn and Developmental Pediatrics at Sunnybrook.
Women typically receive a course of corticosteroids when preterm delivery appears to be imminent, as the drug is most effective between 48 hours and seven days after being administered. However, half of women do not end up giving birth during that timeframe, and may not deliver their babies for several more weeks, potentially requiring another course of corticosteroids.
Dr. Asztalos and her colleagues examined whether administering additional courses of corticosteroids impacted the brain development of the babies, five years after birth. The study followed 1,719 children.
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Multiple courses of steroids for preterm birth unnecessary
TORONTO, Ontario (October 14, 2013) - There are no additional health benefits for preterm babies whose mothers received multiple courses of corticosteroids before giving birth, even five years later, a new Sunnybrook-led study has found.
"Corticosteroids are administered to women at risk of giving birth to their babies preterm, between 24 and 33 weeks gestation, as it can enhance lung maturity in preterm babies. However, the long-term effects on babies whose mothers received corticosteroids multiple times, as opposed to once, were not clear," says principle investigator Dr. Elizabeth Asztalos, Staff Neonatologist, Department of Newborn and Developmental Pediatrics at Sunnybrook Health Sciences Centre.
Women typically receive a course of corticosteroids when preterm delivery appears to be imminent, as the drug is most effective between 48 hours and seven days after being administered. However, half of women do not end up giving birth during that timeframe, and may not deliver their babies for several more weeks, potentially requiring another course of corticosteroids.
Dr. Asztalos and her colleagues examined whether administering additional courses of corticosteroids impacted the brain development of the babies, five years after birth. The study followed 1,719 children who were split into two groups: those whose mothers had received one course of corticosteroids before giving birth, and those whose mothers received multiple courses. Mortality and neurodevelopmental disability, such as cerebral palsy, blindness, deafness or abnormal attention or behavior in the children was measured.
Dr. Asztalos and her colleagues found no increase or decrease in the risk of death or disability for the children at age five.
"We found no negative effects of multiple courses of corticosteroids on the children five years later, but we didn't find any benefits either. Because there is nothing to gain by administering the drug multiple times, our recommendation is that women at risk of giving birth preterm should only receive corticosteroids once," says Dr. Asztalos, who is also Director, Centre for Mother, Infant and Child Research (CMICR) at Sunnybrook Research Institute and Associate Professor at the University of Toronto.
The study, which was published today by JAMA Pediatrics, a Journal of the American Medical Association Network publication, was funded by the Canadian Institutes of Health Research (CIHR).
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Sybil Edmonds
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