Antenatal corticosteroids for preterm birth: dose‐dependent reduction in birthweight, length and head circumference
- 5 November 2010
- journal article
- research article
- Published by Wiley in Acta Paediatrica
- Vol. 100 (3), 364-369
- https://doi.org/10.1111/j.1651-2227.2010.02074.x
Abstract
Aim: This study was undertaken to evaluate the effects of repeated courses of antenatal corticosteroids (ACS) on foetal growth. Methods: We studied 94 infants exposed to 2–9 courses of ACS. Mean gestational age (GA) at first exposure was 29 and at birth 34 weeks. Exposure data were retrieved from case record files. Information on potential confounders was collected from the Swedish Medical Birth Registry. Standard deviation scores (SDS) for birthweight (BW), birthlength (BL) and head circumference (HC) were calculated and considered as outcomes. Results: GA at start of ACS did not affect outcome. BW‐SDS, BL‐SDS and HC‐SDS were −0.21, −0.19 and +0.25 in infants exposed to two courses, compared to −1.01, −1.04 and −0.23 in infants exposed to ≥4 courses of ACS (p = 0.04–0.07). In multiple regression analyses, ≥4 courses were associated with lower BW‐SDS, BL‐SDS and HC‐SDS (p = 0.007–0.04) compared to SDS after 2–3 courses. The effects from ≥4 courses on BW and BL were comparable to reduction in birth size seen in twins and on HC to that observed after maternal smoking. Conclusions: Multiple courses of ACS are associated with a dose‐dependent decline in foetal growth, which may affect later development and health.Keywords
This publication has 20 references indexed in Scilit:
- Does in utero exposure to synthetic glucocorticoids influence birthweight, head circumference and birth length? A systematic review of current evidence in humansPaediatric and Perinatal Epidemiology, 2010
- Continuous growth reference from 24thweek of gestation to 24 months by genderBMC Pediatrics, 2008
- Long-Term Outcomes after Repeat Doses of Antenatal CorticosteroidsThe New England Journal of Medicine, 2007
- Outcomes at 2 Years of Age after Repeat Doses of Antenatal CorticosteroidsThe New England Journal of Medicine, 2007
- Single versus weekly courses of antenatal corticosteroids: Evaluation of safety and efficacyAmerican Journal of Obstetrics and Gynecology, 2006
- Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birthPublished by Wiley ,2006
- Unstudied infants: outcomes of moderately premature infants in the neonatal intensive care unitArchives of Disease in Childhood: Fetal & Neonatal, 2006
- Two-year infant neurodevelopmental outcome after single or multiple antenatal courses of corticosteroids to prevent complications of prematurityAmerican Journal of Obstetrics and Gynecology, 2004
- Are we prescribing multiple courses of antenatal corticosteroids? A survey of practice in the UKBJOG: An International Journal of Obstetrics and Gynaecology, 1999
- Repetitive Prenatal Glucocorticoids Improve Lung Function and Decrease Growth in Preterm LambsAmerican Journal of Respiratory and Critical Care Medicine, 1997