Prenatal Betamethasone Not Linked to Later Adverse Neurocognitive Problems
Corticosteroids are Safe for Children
Press Release: March 8, 2019
Gainesville Fl., March 15, 2019 (swampstrattcomm-sp.19.tumblr.com) – The recent articles in MDedge consisted of features on the increasing maternal morbidity, and studies on patients’ experiences during pregnancy with diagnosis of medical conditions such as multiple sclerosis. It also included articles on how patients could improve outcomes, and limit possible pregnancy risks. The articles however, mostly focused on the latest news on FDA approved drugs and medications after positive findings in patients with varying conditions. These medications not only affected the mother positively, but the infant as well. One such circumstance was with prenatal betamethasone. Preterm birth can cause an array of medical conditions and defects, however, due to drugs such as the corticosteroid betamethasone, a mother can delay the delivery in order for the infant to continue to develop properly (Healthline).
A new study has found that administering prenatal corticosteroids to pre-term pregnant women does not put the infant at risk to neurocognitive conditions six to eight years later, regardless of possible fetal growth restriction. Despite this however, there was some apprehension concerning the possible long-term effects of multiple steroid doses on an infant. Several animal studies conducted suggested that administering steroids could harm the immune system, neurological development, and growth (Healthline), which led researchers and health professionals to believe that injecting steroids could cause fetal growth restriction and severe neurological conditions (MDedge). However, a study by the Australian Collaborative Trial of Repeat Doses of Corticosteroids (ACTORDS) proved that the benefits of corticosteroids and lack of adverse effects out weighted possible fetal growth restriction. “Physicians should use repeated doses of antenatal corticosteroids when indicated before preterm birth, regardless of fetal growth restriction, in view of the associated neonatal benefits and absence of later adverse effects,” the authors concluded (MDedge).
The study included 1,146 fetuses and 982 pregnant women who were less than 32 weeks’ gestation, and were at risk of preterm birth for at least seven days. The women were randomly assigned to receive betamethasone or a saline placebo weekly. A follow-up was conducted when the children were six to eight years old, where they received several exams, including a neurological and physical exam. Fetal growth restriction (FGR) occurred in 28% of children who received betamethasone and 25% who received the placebo. Those with FGR had a greater risk of death, moderate to severe disability, and motor impairment than those without FGR regardless of treatment group. Infants with FGR had an increased benefit from continuous antenatal corticosteroid therapy; however, there is concern with whether repeated antenatal corticosteroid therapy could risk ADHD (MDedge).
Various studies like this one have proved that corticosteroids, more specifically betamethasone, are in fact safe for children, and do not cause harmful effects later on in life. Although more research still needs to be conducted about the effects of continuous corticosteroid injections, it is safe to say that the benefits of these steroids for preterm infants out weight the possible drawbacks.
MDedge: ObGyn is a trade journal that includes various articles on cutting edge and relevant news in the medical field of obstetrics and gynecology. Its news is delivered by experts in the field, and includes clinical reviews and recent research. It also includes content offered from the publications of OBG MANAGEMENT and Ob.Gyn.News.
Contact:
Alexandra Bernard
@Dr.Awesome-1