Christopher J D McKinlay1,2,3, Wayne S Cutfield1,4, Malcolm R Battin1,5, Stuart R Dalziel1,6, Caroline A Crowther1,7, Jane E Harding8. 1. Liggins Institute and. 2. Department of Paediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand. 3. Kidz First Neonatal Care, Counties Manukau Health, Auckland, New Zealand. 4. A Better Start, National Science Challenge, Auckland, New Zealand. 5. Newborn Services, National Women's Health, Auckland City Hospital, Auckland, New Zealand. 6. Children's Emergency Department, Starship Children's Health, Auckland, New Zealand; and. 7. Australian Research Centre for Health of Women and Babies, Robinson Research Institute, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia. 8. Liggins Institute and j.harding@auckland.ac.nz.
Abstract
BACKGROUND AND OBJECTIVE: Treatment of women at risk for preterm birth with repeat doses of glucocorticoids reduces neonatal morbidity, but could have adverse effects on skeletal development. We assessed whether exposure to repeat antenatal betamethasone alters bone mass in children whose mothers participated in the Australasian Collaborative Trial of Repeat Doses ofCorticosteroids. METHODS: Women were randomized to a single dose of betamethasone or placebo, ≥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 underwent whole-body dual-energy radiograph absorptiometry at 6 to 8 years' corrected age. RESULTS: Of 212 eligible childhood survivors, 185 were studied (87%; 91 repeat betamethasone group; 94 placebo [single course] group). Children exposed to repeat antenatal betamethasone and those exposed to placebo had similar whole-body bone mineral content (median repeatbetamethasone: 553 g, interquartile range: 442-712 g; placebo: 567 g, interquartile range: 447-750 g; geometric mean ratio: 0.99; 95% confidence interval: 0.94-1.03, P = .55) and bone area (median repeatbetamethasone 832 cm2, interquartile range: 693-963 cm2; placebo: 822 cm2, interquartile range: 710-1020 cm2; geometric mean ratio: 0.99, 95% confidence interval: 0.92-1.07, P = .75). CONCLUSIONS: Exposure to repeat doses of antenatal betamethasone compared with a single course of glucocorticoids does not alter bone mass in mid-childhood.
RCT Entities:
BACKGROUND AND OBJECTIVE: Treatment of women at risk for preterm birth with repeat doses of glucocorticoids reduces neonatal morbidity, but could have adverse effects on skeletal development. We assessed whether exposure to repeat antenatal betamethasone alters bone mass in children whose mothers participated in the Australasian Collaborative Trial of Repeat Doses of Corticosteroids. METHODS:Women were randomized to a single dose of betamethasone or placebo, ≥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 underwent whole-body dual-energy radiograph absorptiometry at 6 to 8 years' corrected age. RESULTS: Of 212 eligible childhood survivors, 185 were studied (87%; 91 repeat betamethasone group; 94 placebo [single course] group). Children exposed to repeat antenatal betamethasone and those exposed to placebo had similar whole-body bone mineral content (median repeat betamethasone: 553 g, interquartile range: 442-712 g; placebo: 567 g, interquartile range: 447-750 g; geometric mean ratio: 0.99; 95% confidence interval: 0.94-1.03, P = .55) and bone area (median repeat betamethasone 832 cm2, interquartile range: 693-963 cm2; placebo: 822 cm2, interquartile range: 710-1020 cm2; geometric mean ratio: 0.99, 95% confidence interval: 0.92-1.07, P = .75). CONCLUSIONS: Exposure to repeat doses of antenatal betamethasone compared with a single course of glucocorticoids does not alter bone mass in mid-childhood.
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: Sean C Blackwell; Erin M Sullivan; Allison A Petrilla; Xian Shen; Kathleen A Troeger; James D Byrne Journal: Clinicoecon Outcomes Res Date: 2017-10-03
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