March 2009. Volume 5. Number 1

Repeated course of prenatal corticosteroids for women at risk of preterm birth is not recommended

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Murphy KE, Hannah ME, Willan AR, Hewson SA, Ohlsson A, Nelly EN, et al. Multiple course of antenatal corticosteroids for preterm birth (MACS): a randomised controlled trial. Lancet. 2008;372:2143-51
Reviewers: González de Dios J1, Balaguer Santamaría A2.
1Departamento de Pediatrí­a. Hospital General Universitario de Alicante. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 30/01/2009
Acceptance date: 30/01/2009
Publication date: 31/01/2009

Abstract

Authors' conclusions: repeated course of antenatal corticosteroids (every 14 days) is not recommended for a bad relationship between efficiency (no improvement neonatal morbi-mortality) and security (decrease the weight, height and head circumference at birth).

Reviewers' comantary: the reduction of foetal growth by use of repeated courses of corticosteroids, given the discrepancy results from short term effectiveness of this multicenter clinical trial quality (1.858 pregnant women) and the systematic review published previously (2.008 pregnant women from 5 clinical trials) make recommend a single cycle of steroids on the risk of premature birth, supported also by the limited information on current long-term effects of the use of steroids in the foetus.

How to cite this article

González de Dios J, Balaguer Santamaría A. No se recomienda la utilización de ciclos múltiples de corticoides prenatales en el riesgo de parto prematuro. Evid Pediatr. 2009;5:8.

AVC | Critically appraised articles

Murphy KE, Hannah ME, Willan AR, Hewson SA, Ohlsson A, Nelly EN, et al. Multiple course of antenatal corticosteroids for preterm birth (MACS): a randomised controlled trial. Lancet. 2008;372:2143-51
Reviewers: González de Dios J1, Balaguer Santamaría A2.
1Departamento de Pediatrí­a. Hospital General Universitario de Alicante. España.
2H General Catalunya. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Javier González de Dios. Email: javier.gonzalezdedios@gmail.com
Reception date: 30/01/2009
Acceptance date: 30/01/2009
Publication date: 31/01/2009

How to cite this article

González de Dios J, Balaguer Santamaría A. No se recomienda la utilización de ciclos múltiples de corticoides prenatales en el riesgo de parto prematuro. Evid Pediatr. 2009;5:8.

References

  1. Committee on Obstetric Practice. ACOG Committee opinion: antenatal corticosteroid therapy for fetal maturation. Obstet Gynecol. 2002;99:871.
  2. Miracle X, Di Renzo GC, Stark A, Fanaroff A, Carbonell-Strany X, Saling E (Coordinators of WAPM Prematurity Working Group). Guideline for the use of antenatal corticosteroids for fetal maturation. J Perinat Med. 2008;36:191-6.
  3. Crowther CA, Haslam RR, Hiller JE, Doyle LW, Robison JS, for the Australasian Collaborative Trial of Repeat Doses of Steroids (ACTORDS) Study Group. Neonatal respiratory distress syndrome after repeat exposure to antenatal corticosteroids: a randomised controlled trial. Lancet. 2006;367:1913-9.
  4. Crowther CA, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease. Cochrane Database Sys Rev. 2007;3:CD003935
  5. Wapner RJ, Sorokin Y, Mele L, et al.Long-term outcomes after repeat doses of antenatal corticosteroids. N Engl J Med. 2007;357(12):1190-8.
31/01/2009

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