Two-year follow-up of a randomised trial with repeated antenatal betamethasone
- 1Department of Paediatrics, University of Oulu, Oulu, Finland
- 2Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
- 3Department of Paediatrics, University of Turku, Turku, Finland
- 4Department of Paediatrics, University Hospital of Tampere, Tampere, Finland
- Correspondence to Outi M Peltoniemi, Department of Paediatrics, University of Oulu, P.O. Box 5000, FIN-90014 University of Oulu, Finland; outi.peltoniemi{at}mail.suomi.net
- Accepted 26 May 2009
- Published Online First 15 June 2009
Abstract
Background: Weekly repeated antenatal corticosteroid treatment improves respiratory outcome but decreases fetal growth and may impair neurodevelopmental outcome. We have previously reported that a single repeat betamethasone (BM) dose neither decreased fetal growth nor improved the outcome of preterm infants during the first hospitalisation.
Objective: To study prospectively whether a single repeat dose of BM influences neurodevelopment and growth within 2 years.
Design: Women with imminent delivery before 34.0 gestational weeks were eligible if they remained undelivered for >7 days after a single course of antenatal BM. After stratification, a single repeat dose of BM (12 mg) or placebo was given. The children underwent neurological and psychometric examinations and a speech evaluation at a corrected age of 2 years.
Setting: Prospective, blinded evaluation following the randomised multicentre trial.
Patients: 259 (82%) surviving infants completed the 2-year follow-up, 120 in the BM group and 139 in the placebo group.
Results: The rate of survival without severe neurodevelopmental impairment was similar in both groups (BM 98%, placebo 99%). The risk of cerebral palsy (BM 2%, placebo 1%), growth or re-hospitalisation rates (BM 60%, placebo 50%) did not differ between the groups.
Conclusions: A single repeat dose of antenatal BM tended not to influence physical growth or neurodevelopment at 2 years of age.
Footnotes
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↵*OMP, P Olsen, T Saarela, MH (Department of Paediatrics, Oulu University Hospital, Oulu, Finland); MAK, AL, RP, H Heiskala, S Andersson (Children’s Hospital, Helsinki University Central Hospital, Helsinki, Finland); K Nikolajev (Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland); OT (Department of Paediatrics, University Hospital of Tampere, Tampere, Finland); LL (Department of Paediatrics, University Hospital of Turku, Turku, Finland).
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Funding Supported by grants from the Foundation for Paediatric Research, the Alma and K.A. Snellman Foundation (Oulu, Finland), the Arvo and Lea Ylppö Foundation and the Sigrid Juselius Foundation (Finland).
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Competing interests None.
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Ethics approval The protocol was approved by the ethics committee of Oulu University Hospital and by the National Agency for Medicines.
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Patient consent Parental consent obtained.
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Provenance and Peer review Not commissioned; externally peer reviewed.
