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More Risks than Benefits for Prenatal Multiple Course Steroids

Lauren Lopez3 years ago

After examining five year data, researchers now advise against the use of multiple courses of steroids in premature infants. These findings are contrary to those gathered previously by a Cochrane review.

About the Prenatal Steriod Study

  • According to a doctor with The Centre for Mother, Infant, and Child Research at Sunnybrook Research Institute in Toronto, “at five years, children in the Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS) had similar rates of death or disability in both the multiple- and single-course groups (24.9% versus 24.8%, odds ratio 1.02, 95% CI 0.81-1.29, P=0.84)”.
  • According to MedPage Today, there is currently a void of strong and conclusive evidence supporting the benefits of multiple courses in both the long and short term use.
  • Researchers who conducted the five year study review maintain that multiple courses are not recommended in women with ongoing risk of preterm birth.

Previous Study and Findings

  • Years previous, the Australian Research Centre for Health of Women and Babies at the University of Adelaide conducted several reviews and randomized controlled trials as to the effectiveness of prenatal steroids.
  • In summary, the analysis of ten controlled trials consisting of 4,730 women and 5,650 babies revealed that multiple courses of prenatal steroids resulted in a 17% reduced risk of respiratory distress syndrome. 
  • According to the data, there were no differences in birthrate or any serious health issues weeks after the birth.
Long-Term Effects of Prenatal Steroids

This review may be the first long-term, follow-up study to identify a subject group of infants who did not benefit from multiple course steroids. Evidence showed an increased risk of a difficulty later on in childhood.

Though giving a second course of steroids may improve the initial breathing short term, giving or not giving a second course does not appear to have an increased benefit when looking into the survival of the infant or how the child will be in five years.

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