Fetal growth restriction: repeated betamethasone does not affect later neurocognitive status

  • Cartwright RD & al.
  • JAMA Netw Open
  • 1 Feb 2019

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Repeated doses of betamethasone during pregnancy

Why this matters

  • Concern over repeated doses of betamethasone in the setting of FGR may be unfounded.

Key results

  • Repeated betamethasone exposure was not associated with any adverse neurocognitive effects at age 6-8 years in children with and without FGR.
  • Regardless of treatment exposure, children with FGR had an increased risk of morbidity compared with those without FGR.

Study design

  • Preplanned secondary analysis of the ACTORDS trial, a placebo-controlled, randomized clinical trial of repeated antenatal betamethasone administered
  • Surviving children who participated in the ACTORDS trial were invited to participate and underwent physical, psychological, and neurologic exam at age 6-8 years as part of the Midchildhood Outcomes Study.
  • Study participants (n=493) were compared with a control group (n=495); participants were further stratified into FGR and non-FGR groups.
  • Funding: National Health Medical Research Council of Australia, Health Research Council of New Zealand, Auckland Medical Research Foundation.

Limitations

  • Small numbers in study.
  • FGR defined as less than a third percentile.

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