Christopher J D McKinlay1, Wayne S Cutfield1, Malcolm R Battin2, Stuart R Dalziel3, Caroline A Crowther4, Jane E Harding5. 1. Liggins Institute, The University of Auckland, Auckland, New Zealand; 2. Newborn Services, National Women's Health, Auckland City Hospital, Auckland, New Zealand; 3. Children's Emergency Department, Starship Children's Health, Auckland, New Zealand; and. 4. Liggins Institute, The University of Auckland, Auckland, New Zealand; Australian Research Centre for Health of Women and Babies, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, Australia. 5. Liggins Institute, The University of Auckland, Auckland, New Zealand; j.harding@auckland.ac.nz.
Abstract
BACKGROUND: Treatment of women at risk for preterm birth with repeat doses of glucocorticoids reduces neonatal morbidity but could have adverse long-term effects on cardiometabolic health in offspring. We assessed whether exposure to repeat antenatal betamethasone increased risk factors for later cardiometabolic disease in children whose mothers participated in the Australasian Collaborative Trial of Repeat Doses ofCorticosteroids. METHODS: Women were randomized to betamethasone or placebo treatment, ≥ 7 days after an initial course of glucocorticoids, repeated each week that they remained at risk for preterm birth at <32 weeks' gestation. In this follow-up study, children were assessed at 6 to 8 years' corrected age for body composition, insulin sensitivity, ambulatory blood pressure, and renal function. RESULTS: Of 320 eligible childhood survivors, 258 were studied (81%; 123 repeat betamethasone group; 135 placebo [single course] group). Children exposed to repeat antenatal betamethasone and those exposed to placebo had similar total fat mass (geometric mean ratio 0.98, 95% confidence interval [CI] 0.78 to 1.23), minimal model insulin sensitivity (geometric mean ratio 0.89, 95% CI 0.74 to 1.08), 24-hour ambulatory blood pressure (mean difference systolic 0 mm Hg, 95% CI -2 to 2; diastolic 0 mm Hg, 95% CI -1 to 1), and estimated glomerular filtration rate (mean difference 1.2 mL/min/1.73 m(2), 95% CI -3.2 to 5.6). CONCLUSIONS: Exposure to repeat doses of antenatal betamethasone compared with a single course of glucocorticoids does not increase risk factors for cardiometabolic disease at early school age.
RCT Entities:
BACKGROUND: Treatment of women at risk for preterm birth with repeat doses of glucocorticoids reduces neonatal morbidity but could have adverse long-term effects on cardiometabolic health in offspring. We assessed whether exposure to repeat antenatal betamethasone increased risk factors for later cardiometabolic disease in children whose mothers participated in the Australasian Collaborative Trial of Repeat Doses of Corticosteroids. METHODS:Women were randomized to betamethasone or placebo treatment, ≥ 7 days after an initial course of glucocorticoids, repeated each week that they remained at risk for preterm birth at <32 weeks' gestation. In this follow-up study, children were assessed at 6 to 8 years' corrected age for body composition, insulin sensitivity, ambulatory blood pressure, and renal function. RESULTS: Of 320 eligible childhood survivors, 258 were studied (81%; 123 repeat betamethasone group; 135 placebo [single course] group). Children exposed to repeat antenatal betamethasone and those exposed to placebo had similar total fat mass (geometric mean ratio 0.98, 95% confidence interval [CI] 0.78 to 1.23), minimal model insulin sensitivity (geometric mean ratio 0.89, 95% CI 0.74 to 1.08), 24-hour ambulatory blood pressure (mean difference systolic 0 mm Hg, 95% CI -2 to 2; diastolic 0 mm Hg, 95% CI -1 to 1), and estimated glomerular filtration rate (mean difference 1.2 mL/min/1.73 m(2), 95% CI -3.2 to 5.6). CONCLUSIONS: Exposure to repeat doses of antenatal betamethasone compared with a single course of glucocorticoids does not increase risk factors for cardiometabolic disease at early school age.
Authors: Jane E Harding; Aakash Bajirao Rajay; Jane Marie Alsweiler; Gavin Brown; Caroline Anne Crowther; Nike Franke; Greg Gamble; Christopher McKinlay; Barry Milne; Jenny Rogers; Trecia Wouldes Journal: BMJ Open Date: 2022-07-13 Impact factor: 3.006
Authors: Gary P Brennan; Dimitrios M Vitsios; Sophie Casey; Ann-Marie Looney; Boubou Hallberg; David C Henshall; Geraldine B Boylan; Deirdre M Murray; Catherine Mooney Journal: PLoS One Date: 2018-12-03 Impact factor: 3.240
Authors: Robert D Cartwright; Caroline A Crowther; Peter J Anderson; Jane E Harding; Lex W Doyle; Christopher J D McKinlay Journal: JAMA Netw Open Date: 2019-02-01
Authors: Katie Wynne; Christopher Rowe; Matthew Delbridge; Brendan Watkins; Karina Brown; Jordan Addley; Andrew Woods; Henry Murray Journal: F1000Res Date: 2020-03-30