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Comment & Response |

More Evidence That Unnecessary Antenatal Treatments Cause Harm–Reply

Elizabeth V. Asztalos, MD, MSc1; Andrew R. Willan, PhD2; Stephen G. Matthews, PhD3,4,5
[+] Author Affiliations
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, Canada
4Department of Obstetrics and Gynaecology, Fraser Mustard Institute of Human Development, University of Toronto, Toronto, Ontario, Canada
5Department 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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In Reply We thank Stock and Kemp for their comments on our findings reported in the article “Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study: Outcomes in Children at 5 Years of Age (MACS-5).”1 We do, however, wish to point out that the significant findings related to neurosensory dysfunction (odds ratio, 3.70 [95% CI, 1.57-8.75]; P = .004) were confined to children who were born at term gestation and were subjected to at least 1 additional course of antenatal corticosteroids. The effect was not observed in the children born preterm. Further analysis is being undertaken to evaluate the association between antenatal corticosteroid exposure, gestational age at birth, and outcomes.

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April 1, 2014
Sarah J. Stock, MBChB, PhD; Matthew W. Kemp, PhD
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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