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Comment & Response |

More Evidence That Unnecessary Antenatal Treatments Cause Harm

Sarah J. Stock, MBChB, PhD1; Matthew W. Kemp, PhD2
[+] Author Affiliations
1Department of Maternal Fetal Medicine, University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, Scotland
2University of Western Australia School of Women’s and Infants’ Health, Crawley, Western Australia, Australia
JAMA Pediatr. 2014;168(4):389. doi:10.1001/jamapediatrics.2013.5241.
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To the Editor We read with interest the article “Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study: Outcomes in Children at 5 Years of Age (MACS-5).”1 Asztalos et al, as well as the supporting funding bodies, must be congratulated on ensuring long-term follow-up of the participants in this important trial. No benefit was conferred by multiple doses of antenatal corticosteroids on the primary outcome, a composite of death or neurodevelopmental disability at 5 years of age. Indeed, more children who had multiple courses of steroids in utero had a deficit in neurosensory function (odds ratio, 3.70 [95% CI, 1.57-8.75]; P = .004). Along with the findings of the ORACLE follow-up,2 theses studies highlight the long-term damage that can result from administration of therapies in pregnancy that were previously thought to be innocuous.

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April 1, 2014
Elizabeth V. Asztalos, MD, MSc; Andrew R. Willan, PhD; Stephen G. Matthews, PhD
1Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
2Program in Child Health Evaluative Sciences, SickKids Research Institute, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
3Department of Physiology, Fraser Mustard Institute of Human Development, University of Toronto, Toronto, Ontario, Canada4Department of Obstetrics and Gynaecology, Fraser Mustard Institute of Human Development, University of Toronto, Toronto, Ontario, Canada5Department of Medicine, Fraser Mustard Institute of Human Development, University of Toronto, Toronto, Ontario, Canada
JAMA Pediatr. 2014;168(4):389-390. doi:10.1001/jamapediatrics.2013.5244.
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