Postnatal betamethasone treatment in extremely preterm infants and risk of neurodevelopmental impairment : a cohort study
(2025) In Archives of Disease in Childhood: Fetal and Neonatal Edition 110(4). p.382-387- Abstract
Objective: To evaluate if postnatal treatment with betamethasone in extremely preterm infants was associated with neurodevelopmental impairment (NDI) at 6.5 years of age. Design: Prospective cohort study. Setting: Extremely Preterm Infants in Sweden Study (gestational age <27 weeks, born 2004-2007). Patients: 428 children born extremely preterm were assessed at 6.5 years of age, 115 treated with betamethasone and 313 not treated. Main outcome measures: NDI at 6.5 years of age. Evaluation at 6.5 years included cognitive testing with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), neurological examination and a medical record review. Exposure: Treatment with postnatal betamethasone. Main outcome: Moderate to... (More)
Objective: To evaluate if postnatal treatment with betamethasone in extremely preterm infants was associated with neurodevelopmental impairment (NDI) at 6.5 years of age. Design: Prospective cohort study. Setting: Extremely Preterm Infants in Sweden Study (gestational age <27 weeks, born 2004-2007). Patients: 428 children born extremely preterm were assessed at 6.5 years of age, 115 treated with betamethasone and 313 not treated. Main outcome measures: NDI at 6.5 years of age. Evaluation at 6.5 years included cognitive testing with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), neurological examination and a medical record review. Exposure: Treatment with postnatal betamethasone. Main outcome: Moderate to severe NDI at 6.5 years of age, defined as a composite including cerebral palsy, and/or impairment in cognition, hearing and vision. Results: Moderate to severe NDI was more prevalent in children treated with postnatal betamethasone (49% treated vs 26% not treated, p<0.001). Betamethasone-treated children had worse cognitive development with mean WISC-IV score of 75 (SD 13.7) vs 87 (SD 14.0, p<0.001). The effect was dose dependent: 1.35 mg/kg vs 1.0 mg/kg (p=0.01) in betamethasone-treated children with moderate to severe versus no or mild NDI, respectively. The differences remained after adjustment for potential confounders with logistic regression (adjusted OR (aOR) 1.80, 95% CI 1.14 to 3.21). The difference in NDI also remained after propensity score matching, with crude OR 2.82 (95% CI 1.42 to 5.61, p=0.003) and aOR 2.17 (95% CI 1.07 to 4.69, p=0.04). Conclusion: Postnatal treatment with betamethasone is associated with increased risk of NDI at 6.5 years.
(Less)
- author
- Löfberg, Linn ; Serenius, Fredrik ; Hellstrom-Westas, Lena ; Olhager, Elisabeth LU ; Ley, David LU ; Farooqi, Aijaz ; Stephansson, Olof and Abrahamsson, Thomas
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Neonatology, Neurodevelopment
- in
- Archives of Disease in Childhood: Fetal and Neonatal Edition
- volume
- 110
- issue
- 4
- pages
- 6 pages
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:39694682
- scopus:85213844347
- ISSN
- 1359-2998
- DOI
- 10.1136/archdischild-2024-327360
- language
- English
- LU publication?
- yes
- id
- 93235cc1-7ddf-4611-8758-6e1665fbba51
- date added to LUP
- 2025-03-12 14:52:54
- date last changed
- 2025-07-03 01:12:41
@article{93235cc1-7ddf-4611-8758-6e1665fbba51,
abstract = {{<p>Objective: To evaluate if postnatal treatment with betamethasone in extremely preterm infants was associated with neurodevelopmental impairment (NDI) at 6.5 years of age. Design: Prospective cohort study. Setting: Extremely Preterm Infants in Sweden Study (gestational age <27 weeks, born 2004-2007). Patients: 428 children born extremely preterm were assessed at 6.5 years of age, 115 treated with betamethasone and 313 not treated. Main outcome measures: NDI at 6.5 years of age. Evaluation at 6.5 years included cognitive testing with the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV), neurological examination and a medical record review. Exposure: Treatment with postnatal betamethasone. Main outcome: Moderate to severe NDI at 6.5 years of age, defined as a composite including cerebral palsy, and/or impairment in cognition, hearing and vision. Results: Moderate to severe NDI was more prevalent in children treated with postnatal betamethasone (49% treated vs 26% not treated, p<0.001). Betamethasone-treated children had worse cognitive development with mean WISC-IV score of 75 (SD 13.7) vs 87 (SD 14.0, p<0.001). The effect was dose dependent: 1.35 mg/kg vs 1.0 mg/kg (p=0.01) in betamethasone-treated children with moderate to severe versus no or mild NDI, respectively. The differences remained after adjustment for potential confounders with logistic regression (adjusted OR (aOR) 1.80, 95% CI 1.14 to 3.21). The difference in NDI also remained after propensity score matching, with crude OR 2.82 (95% CI 1.42 to 5.61, p=0.003) and aOR 2.17 (95% CI 1.07 to 4.69, p=0.04). Conclusion: Postnatal treatment with betamethasone is associated with increased risk of NDI at 6.5 years.</p>}},
author = {{Löfberg, Linn and Serenius, Fredrik and Hellstrom-Westas, Lena and Olhager, Elisabeth and Ley, David and Farooqi, Aijaz and Stephansson, Olof and Abrahamsson, Thomas}},
issn = {{1359-2998}},
keywords = {{Neonatology; Neurodevelopment}},
language = {{eng}},
number = {{4}},
pages = {{382--387}},
publisher = {{BMJ Publishing Group}},
series = {{Archives of Disease in Childhood: Fetal and Neonatal Edition}},
title = {{Postnatal betamethasone treatment in extremely preterm infants and risk of neurodevelopmental impairment : a cohort study}},
url = {{http://dx.doi.org/10.1136/archdischild-2024-327360}},
doi = {{10.1136/archdischild-2024-327360}},
volume = {{110}},
year = {{2025}},
}