Antenatal corticosteroids and outcome at 14 years of age in children with birth weight less than 1501 grams

Objective. To determine whether exposure to antenatal corticosteroid therap y was associated with adverse effects on growth, sensorineural outcome, or lung function of children of birth weight <1501 g at 14 years of age. Design. Cohort study. Setting. The Royal Women's Hospital, Melbourne, Australia. Subjects. One hundred fifty-four consecutive survivors born from October 1, 1980 to March 31, 1982. Interventions. The mothers of 78 survivors (51%) had been given corticoster oids antenatally to accelerate fetal lung maturation. Treatment with antena tal corticosteroids was nonrandom. No mother received >1 course of corticos teroids. Outcome Measures. The children were assessed at 14 years of age, corrected for prematurity. All assessors were unaware of the exposure of the child to antenatal corticosteroids. The assessments included measurements of growth and neurological, cognitive, and lung function. Growth measurements were c onverted into z scores (standard deviation) for the appropriate age and gen der. Results. Of the 154 survivors, 130 (84%) were assessed at 14 years of age. Overall, the children exposed to antenatal corticosteroids were significant ly taller (height z score; mean difference: .39; 95% confidence interval: . 001-.79) and had better cognitive functioning (Wechsler Intelligence Scale for Children-Third Edition Full Scale; IQ mean difference: 6.2; 95% confide nce interval: .8-11.6) than those not exposed to corticosteroids. There wer e no other differences in sensorineural outcomes between the groups. Lung f unction was not significantly different between the groups. No conclusions were altered by adjustment for confounding variables. Conclusions. Exposure to 1 course of antenatal corticosteroid therapy was a ssociated with some clinically and statistically improved outcomes at 14 ye ars of age in children of birth weight <1501 g, with no obvious adverse eff ects on growth or on sensorineural, cognitive, or lung function.