Repeated antenatal corticosteroids: Size at birth and subsequent development

Abstract

Objective: The objective was to study the effects of repeated antenatal corticosteroids on birth size, growth, and development in preterm infants. Study Design: This observational study followed up for 3 years a prospective geographic cohort in the state of Western Australia of 477 singleton infants born at <33 weeks' gestation. Results: Birth weight ratio decreased with increasing number of corticosteroid courses ( P = .001), and multivariate analyses confirmed a reduction in birth weight of as much as 9% ( P = .014) and a reduction in head circumference of as much as 4% ( P = .0024). There were no additional benefits in mortality or respiratory outcomes, and there was a trend toward more severe chronic lung disease. At age 3 years growth and severe disability outcomes did not appear to be related to increasing number of corticosteroid courses. Conclusions: In this cohort study repeated corticosteroid courses were associated with adverse effects on size at birth without apparent benefits. These changes have the potential to affect later development.(Am J Obstet Gynecol 1999;180:114-21.)