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Two-year follow-up of a randomized trial with repeated antenatal betamethasone
  1. Outi M Peltoniemi (outi.peltoniemi{at}
  1. University of Oulu, Finland
    1. M Anneli Kari
    1. Helsinki University Central Hospital, Finland
      1. Aulikki Lano
      1. Helsinki University Central Hospital, Finland
        1. Anneli Yliherva, PhD
        1. University of Oulu, Finland
          1. Riina Puosi
          1. Helsinki University Central Hospital, Finland
            1. Liisa Lehtonen
            1. University of Turku, Finland
              1. Mikko Hallman
              1. University of Oulu, Finland


                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 foetal growth nor improved the outcome of preterm infants during the first hospitalization.

                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 more than 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 randomized multi-centre 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 rehospitalization rates (BM 60 %, placebo 50 %) did not differ between the groups, either.

                Conclusions: A single repeat dose of antenatal BM tended not to influence physical growth or neurodevelopment at 2 years of age.

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