SMFM 27th Annual Meeting 2007
view the interview video: Antenatal Steroids
Abstract
Objective: In the RCT, repeat courses of ACS improved specific neonatal respiratory outcomes but reduced birth weight and increased IUGR, especially in infants that received 4 or more courses. Here we report the 2 year follow up evaluation.
Study Design: Woman between 24 and 32 weeks gestation remaining pregnant 7 days after an initial course of ACS were randomized to weekly courses of betamethasone or a placebo. Between 22 and 36 months corrected age a physical examination and Bayley MDI and PDI were performed by trained examiners using standardized criteria.
Results: From the 495 women randomized (581 surviving infants), 484 infants (83.3%) had physical exams and 465 (80.0%) had Bayley exams. There were no differences in gestational age at delivery, latency period or frequency of twins. At follow-up (Table), there were no differences in anthropometric measurements or Bayley results. However, more in the repeat group had cerebral palsy (RR 5.68: 95%: CI 0.69, 46.7). 5 of the 6 infants with CP in the repeat group received ≥4 courses and 5 were beyond 33 weeks at delivery. The mean GA at birth of the infants with CP in the repeat group was 35 wks.
Conclusion: At 2 years there was no difference in weight, head circumference, or Bayley scores between infants exposed to single vs. repeat courses of ACS. Although not statistically significant, the rate of CP in infants exposed to multiple courses is concerning. We suggest that exposure to repeat courses of ACS should be limited.
0002-9378/$ - see front matter
doi:10.1016/j.ajog.2006.10.004
American Journal of Obstetrics and Gynecology
Volume 195, Issue 6, Supplement S (December 2006)
Reducing multifetal pregnancy through publicly funded IVF programs
April 26th 2024Learn how a mandatory elective single-embryo transfer policy in publicly funded in vitro fertilization programs significantly decreases multifetal pregnancy rates, offering insights into mitigating risks in assisted reproduction.
Read More
S1E4: Dr. Kristina Adams-Waldorf: Pandemics, pathogens and perseverance
July 16th 2020This episode of Pap Talk by Contemporary OB/GYN features an interview with Dr. Kristina Adams-Waldorf, Professor in the Department of Obstetrics and Gynecology and Adjunct Professor in Global Health at the University of Washington (UW) School of Medicine in Seattle.
Listen
Higher preterm birth risk found following cesarean delivery at full dilation
March 26th 2024Recent research highlights an association between cesarean delivery at full dilation and increased risk of subsequent preterm birth, prompting further investigation into childbirth practices and outcomes.
Read More