Steroid Treatments to Premature Infants May Increase the Chance of Cerebral Palsy
Researchers at Columbia University Medical Center have released the results of their latest study that shows the possibility that repeated courses of a drug normally used to improve the chance of survival in premature infants before they are born, may also have a detrimental effect by increasing the risk of cerebral palsy in those very same children it was designed to save.
The drug that was the subject of the study is a corticosteroid by the name of betamethasone. It is given to women who are at risk of having a premature baby in order to speed up the development of the baby’s immature lungs. One course of the steroid treatment has been shown to be able to reduce the neonatal mortality rate and improve the lung function with very little risk to the infant.
It was the accepted practice for the obstetrician-gynecologist to frequently repeat the course of treatment using the steroids once a week for as long as 10 or 11 weeks, if the woman was still pregnant after she has received the first treatment. That is until the year 2000 when a panel from the National Institute of Health that was concerned with the lack of any information regard in the safety for this repeated dosing, suggested that the repeated courses of treatment should only be administered only to patients who were participants in clinical trials.
One of the first of the clinical trials set out to examine what the long term effects of the treatment was on the children. In the trial, the women who were still pregnant a week after their first treatment with corticosteroids were split into two groups, One group got further treatments, the other group got a placebo and this continued until the babies were born.
The study was conducted by members of the NIH-sponsored Maternal-Fetal Medicine Network. They followed a total of 556 infants who were at the Morgan Stanley Children’s Hospital of New York-Presbyterian Hospital/Columbia as well as in 12 other sites across the country.
The researchers found that by the time they were 2 to 3 years old, the children from the two groups were all physically and neurologically identical, except for the fact that 6 out of the 248 children who were in the group that received the multiple doses of treatment, had been diagnosed with cerebral palsy. In the placebo group, 1 out of the 238 children had cerebral palsy. Each of the mothers of the 6 children from the corticosteroid group who had cerebral palsy had received a minimum of 4 treatments with the drug.
The difference between the number of children in each group with cerebral palsy is not that significant, but since the weekly courses had no long term benefit and had the potential to harm the child, they suggest that doctors do not administer weekly doses.
The lead researcher was Ronald Wapner, M.D., professor of obstetrics and gynecology, Columbia University Medical Center and attending obstetrician and gynecologist at New York-Presbyterian Hospital/Columbia.
Source: Columbia University Medical Center
