Weekly Prenatal Steroids Reduce Birth Weight

No benefit to overall morbidity outcomes

THURSDAY, Sept. 14 (HealthDay News) -- Weekly doses of prenatal steroids do not improve overall outcome and are associated with lower birth weight and smaller size for gestational age compared to a single dose, according to a study published in the September issue of the American Journal of Obstetrics & Gynecology.

Ronald J. Wapner, M.D., of Columbia University College of Physicians and Surgeons in New York, and colleagues conducted a study of women between 23 weeks and 32 weeks of pregnancy who had received one course of steroids seven to 10 days earlier, with a view to randomizing 2,400 women to receive weekly betamethasone or placebo.

The independent data and safety monitoring committee terminated the study when 495 women were enrolled, because although the repeated doses of steroids significantly reduced administration of neonatal surfactants, mechanical ventilation and pneumothoraces, they did not significantly reduce composite primary morbidity. They were also associated with lower birth weight and an increased number of infants who were small for gestational age.

"Our findings suggest that routine weekly repetition of steroids to all women at high risk for preterm birth, in an attempt to assure maximum exposure to those that deliver early, cannot be justified, may be harmful, and requires treatment of infants who receive little or no benefit," the authors concluded.

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