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

Author(s): Peltoniemi OM, Kari MA, Lano A, Yliherva A, Puosi R, Lehtonen L, Tammela O, Hallman M, Repeat Antenatal Betamethasone (RepeatBM) Follow-Up Study Group

Affiliation(s): Department of Paediatrics, University of Oulu, FIN-90014 University of Oulu, Finland. outi.peltoniemi@mail.suomi.net

Publication date & source: 2009-11, Arch Dis Child Fetal Neonatal Ed., 94(6):F402-6. Epub 2009 Jun 15.

Publication type: Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

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.

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