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Steroids Seem Safe for Babies at Risk of Early Birth

But one study raises the possibility of risk of cerebral palsy

By Serena Gordon
HealthDay Reporter


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WEDNESDAY, Sept. 19 (HealthDay News) -- Children exposed to repeated doses of steroids in-utero had no additional growth or neurodevelopmental problems up to three years after birth, two new studies found.

However, one of the studies did find a slight, though not statistically significant, increase in the incidence of cerebral palsy.

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"In our study, the babies with the highest number of repeated steroid injections -- five or more -- we found a non-significant but an increased risk of possible cerebral palsy," said Dr. Ronald Wapner, director of maternal-fetal medicine at Columbia University in New York City.

That doesn't mean women should forgo corticosteroid injections if they're at risk for preterm labor, but repeated doses should be used judiciously, Wapner advised.

"One of the major advances in the health of the preterm neonate has come from giving the mother an injection of steroids to accelerate the maturation of the baby's lungs," he said. "But, the effects of that shot don't last forever. The best guess is probably about seven days."

Because the benefits of the shot don't appear to last more than a week, many obstetricians started giving women at risk of delivering early repeated injections each week until they delivered. "It became a trend in this country, and women get course after course of steroids," Wapner said.

But, he added, no one knew for sure what the exact benefits and hazards of those repeated doses might be.

The two studies -- one in the United States and one in Australia -- were designed to answer those questions. And, in fact, they did find significant benefits from repeated corticosteroid injections.

"Babies with repeated doses needed less mechanical ventilation and had a decreased incidence of lung problems. However, those benefits came at a price," explained Wapner, who said that babies who received the most steroids were smaller on average.

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Copyright © 2007 ScoutNews, LLC. All rights reserved.
Last updated 9/19/2007

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SOURCES: Alan Stiles, M.D., professor and chairman of pediatrics, University of North Carolina, Chapel Hill; Ronald J. Wapner, director of maternal-fetal medicine, Columbia University, New York City; Sept. 20, 2007, New England Journal of Medicine


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