rss
Arch Dis Child Fetal Neonatal Ed 2009;94:F402-F406 doi:10.1136/adc.2008.150250
  • Original article

Two-year follow-up of a randomised trial with repeated antenatal betamethasone

  1. O M Peltoniemi1,
  2. M A Kari2,
  3. A Lano2,
  4. A Yliherva1,
  5. R Puosi2,
  6. L Lehtonen3,
  7. O Tammela4,
  8. M Hallman1
  1. 1
    Department of Paediatrics, University of Oulu, Oulu, Finland
  2. 2
    Hospital for Children and Adolescents, Helsinki University Central Hospital, Helsinki, Finland
  3. 3
    Department of Paediatrics, University of Turku, Turku, Finland
  4. 4
    Department of Paediatrics, University Hospital of Tampere, Tampere, Finland
  1. 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

  • ↵*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).

  • 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).

  • Competing interests None.

  • Ethics approval The protocol was approved by the ethics committee of Oulu University Hospital and by the National Agency for Medicines.

  • Patient consent Parental consent obtained.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. adc.2008.150250v1
    2. 94/6/F402 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.