Repeated courses of a drug that is used to improve the survival of unborn premature babies also may increase the risk of cerebral palsy in those children, according to results from a multi-center study, funded by the National Institutes of Health and led by Ronald Wapner, M.D., professor of obstetrics and gynecology, Columbia University Medical Center and attending obstetrician and gynecologist at NewYork-Presbyterian Hospital/Columbia.
Results of the study are published in the Sept. 20, 2007 issue of the New England Journal of Medicine .
The drug – a corticosteroid called betamethasone – is given to women at risk of premature delivery to hasten the development of their baby's lungs. One course of steroids has been shown to reduce neonatal mortality and improve lung function with little risk to the infant (citation: NIH Consensus Panel on antenatal corticosteroids, 1994).
Up until the year 2000, obstetrician-gynecologists frequently repeated the course of steroids every week, up to 10 to 11 times, in women who remained pregnant after the first course. A NIH panel that year, concerned with the lack of safety data for this practice, suggested multiple courses should be strictly reserved for patients enrolled in clinical trials.
In one of the first such trials to examine the long-term effects of the treatment on the children, women who remained pregnant a week after the initial course of corticosteroids were randomly assigned to weekly courses of corticosteroids or placebo until their babies were born.