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

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.