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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.
Stock SJ, Kemp MW. More Evidence That Unnecessary Antenatal Treatments Cause Harm. JAMA Pediatr. 2014;168(4):389. doi:10.1001/jamapediatrics.2013.5241