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January 9, 2002

Are Weekly Courses of Antenatal Steroids Beneficial or Dangerous?

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor

JAMA. 2002;287(2):187-190. doi:10.1001/jama.287.2.186

To The Editor: Dr Guinn and colleagues1 found that weekly courses of antenatal corticosteroids were not superior to a single course in reducing neonatal morbidity, although their study was terminated early due to safety concerns. Over the past 10 years antepartum corticosteroids have been both the hero and the villain: praised for lower rates of neonatal death and respiratory distress syndrome (RDS),2 but criticized for detrimental effects on birth weight and head circumference when repetitive courses are used.3 Presently, there is a paucity of prospective data to guide the appropriate dosing for patients who remain pregnant 1 week after their initial treatment. Unfortunately, this gap in knowledge has not been filled by the study of Guinn et al. By not completing their randomized controlled trial (RCT) as originally designed, we believe that their conclusions about efficacy may be erroneous.

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