(September 19, 2007 - Insidermedicine) Women at risk of giving birth early often receive injections of steroids to decrease respiratory problems and serious medical problems in their preterm babies. A new study, published in the New England Journal of Medicine, shows that this practice is not associated with serious negative effects at age 2.

This is what we already know about steroid use during pregnancy:
•    Babies who are born prematurely are at higher risk of mental impairment, breathing problems, and disabilities, including cerebral palsy.
•    Giving corticosteroids during pregnancy to women at risk of premature delivery reduces the risk of infant death and long-term problems.
•    Repeat doses of corticosteroids during at-risk pregnancies has been adopted by many practitioners.  However, many agree that this practice needs to be more thoroughly evaluated.

To assess the safety and effectiveness of corticosteroid use during pregnancy, researchers studied close to 1,000 pregnant women at-risk of premature delivery. Half of the women received repeat corticosteroid doses and half received placebo following a single dose. The dose was repeated weekly if the mother was still considered to be at risk of premature delivery.

We spoke to Dr. Stiles, who wrote the editorial for this study, about the results.

The researchers found that of the more than 1,000 children who were alive at age two, there was little difference in the rate of disability between the corticosteroid and placebo groups. As well, the long-term effects of steroid use have not been fully determined; therefore it may be prudent to use the lowest possible doses.

Pregnant women at risk of premature delivery should be aware that single or repeat injections of corticosteroids may help protect their unborn baby. Mothers at-risk for having a preterm baby should be reassured by this study, because benefits of this practice appear to outweigh the risks.

Finally we asked Dr Stiles to comment on how this study applies to women at risk for preterm labour.

For Insidermedicine in Depth, I'm Dr. Susan Sharma.