Repeated antenatal corticosteroids: Size at birth and subsequent development

OBJECTIVE: The objective was to study the effects of repeated antenatal cor ticosteroids on birth size, growth, and development in preterm infants. STU DY DESIGN: This observational study followed up for 3 years a prospective g eographic cohort in the state of Western Australia of 477 singleton infants born at <33 weeks' gestation. RESULTS: Birth weight ratio decreased with i ncreasing number of corticosteroid courses (P = .001), and multivariate ana lyses confirmed a reduction in birth weight of as much as 9% (P = .014) and a reduction in head circumference of as much as 4% (P = .0024). There were no additional benefits in mortality or respiratory outcomes, and there was a trend toward more severe chronic lung disease. At age 3 years growth and severe disability outcomes did not appear to be related to increasing numb er of corticosteroid courses. CONCLUSIONS: In this cohort study repeated co rticosteroid courses were associated with adverse effects on size at birth without apparent benefits. These changes have the potential to affect later development.