Prenatal Corticosteriods to Delay Labor: Safe For Babies?

Corticosteriods have been known to help prevent premature labor; however, they may come with some risks. Image by Brian Hall

Corticosteriods have been known to help prevent premature labor; however, they may come with some risks. Image by Brian Hall

Doctors sometimes give prenatal corticosteriods to pregnant moms to help prevent preterm labor – but do these medications present a risk to the baby – and do multiple treatments help moms and babies?

Preterm birth occurs when a baby is born before the completed 37 weeks of the pregnancy. According to the March of Dimes, about a half a million babies are born prematurely in the United States every year.

Premature babies can suffer short term health problems as well as long term health problems, so doctors do everything possible to keep the mother from going into labor before the baby is full term at 37 weeks.

One way doctors can delay birth is through corticosteriods. In the past, research has been split on whether the risks outweigh the benefits of this treatment. One new study, however, shows that there is no increased risk with the use of multiple corticosteroid treatments – but there may also be no benefit.

Preterm Labor and Prenatal Corticosteroids: New Study

The new study, published in the JAMA Pediatrics journal, found that there is no increased risk of death or disability of the child when the mother takes multiple courses of prenatal corticosteriods in comparison to a single dose.


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Elizabeth V. Asztalos, M.D., of the Sunnybrook Health Sciences Centre, Toronto, Canada and her team of researchers looked at the effects of single use versus multiple uses of prenatal corticosteriods, also known as antenatal steroids.

Researchers examined mothers and babies that were part of the Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS). The MACS study included more than 1,700 mothers and their children. Researchers looked at this group for the risk of death and neurodevelopment problems, including cerebral palsy, blindness, deafness, and abnormal attention, and behavior.

Premature babies are often faced with short and/or long term health problems. Image by ceejayoz

Premature babies are often faced with short and/or long term health problems. Image by ceejayoz

The researchers found that the risk of death or nerodevelopmental disability was similar between mothers who received single vs. multiple doses of prenatal corticosteriods to prevent preterm labor.

Premature Babies and Corticosteroids: Australian Study

Crowther, et al at the Australian Research Centre for Health of Women and Babies at the University of Adelaide performed several systematic reviews of randomized controlled trials. The analysis of 10 trials, made up of 4,730 women and 5,650 babies, found that multiple courses of corticosteriods resulted in a 17 percent lower risk of respiratory distress syndrome, with no difference in birthweight or serious health problems within weeks after birth.

The long-term analysis of two to three years in research that covered 4,170 children, found no evidence of either significant benefit or harm associated with multiple doses of corticosteriods. Researchers concluded that women could receive multiple doses of corticosteriods when they’re still at risk for preterm labor seven or more days after the first dose of corticosteriods.

Conclusion

This new research found that babies of mothers who received multiple doses of prenatal corticosteriods had a 24.9 percent chance of dying or having a nerodevelopement disability, whereas the children of mothers who only received a single dose of prenatal corticosteriod had a statistically-insignificant 24.8 percent chance of dying or having a nerodevelopment disability.

However, Dr. Elizabeth Asztalos and her team concluded that, although there is little difference in the risk between having one corticosteriod verses having multiple steroid treatments, it is their opinion that doctors should not provide multiple corticosteriod treatments, due to the lack of strong conclusive evidence of short term or long term benefits.

Resources:

Asztalos,E.,Murphy,K., Willan, A. Multiple vs. Single Courses of Prenatal Corticosteroids Not Associated with Increased Death, Disability of Children at Age 5. JAMA Pediatrics. (2013). Accessed October 15, 2013.

March of Dimes. Premature Babies. (2012). Accessed October 15, 2013.

Crowther CA, McKinlay CJ, Middleton P, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes. (2011). U.S. National Library of Medicine. Accessed October 15, 2013.

© Copyright 2013 Janelle Vaesa, MPH: Health, All rights Reserved. Written For: Decoded Pregnancy
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