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Antenatal Corticosteroid Tx Tied to Reduction in Birth Size

Reduction in birth size seen for infants born preterm, near term, or at term with ACT exposure

infant on scale

WEDNESDAY, Feb. 27, 2019 (Pharmacist's Briefing) -- Antenatal corticosteroid therapy (ACT) is associated with reductions in birth size for infants, according to a study published online Feb. 26 in PLOS Medicine.

Alina Rodriguez, Ph.D., from Imperial College London, and colleagues conducted an observational register-based study using data for 278,508 live-born singleton births with ≥24 gestational completed weeks to examine whether birth size differed by ACT exposure.

The researchers found that 1.75 percent of women were treated with ACT and >44 percent of exposed infants were born at term. In unadjusted regression analyses, reductions in birth weight (BWT) were seen for exposed versus unexposed infants: −61.26 g, −232.90 g, −171.50 g, and −101.95 g for those born very preterm, preterm, near term, and at term, respectively. In regression analyses adjusted for baseline and medical conditions, significant differences were seen in BWT for exposed versus unexposed infants: −61.54 g, −222.78 g, −159.25 g, −91.62 g for those born very preterm, preterm, near term, and at term, respectively. Infants exposed to ACT weighed less at birth in propensity-score matched analyses: −220.18 g, −140.68 g, and −89.38 g for those born preterm, near term, and at term, respectively. Significant reductions were also seen in birth length and head circumference. During the first seven days of life and beyond, ACT-treated infants received more medical care.

"These findings provide strong evidence indicating ACT is associated with reduced fetal growth in humans and provide an agenda for further studies," the authors write.

One author disclosed financial ties to Novartis, and a second disclosed ties to Apple Tree Pediatrics.

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