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Comment & Response
April 2014

More Evidence That Unnecessary Antenatal Treatments Cause Harm

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

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Pediatr. 2014;168(4):389. doi:10.1001/jamapediatrics.2013.5241

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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