Multiple Courses of Steroids Can Produce Cognitive Delays.

BEAVER CREEK, COLO. -- The University of Utah's experience appears to confirm that multiple courses of steroids given prenatally to hasten fetal lung development in cases of threatened early labor do affect fetal brain development.

In a retrospective study of 625 infants with birth weights of less than 1,500 g, children exposed to multiple courses of steroids were two times more likely to have mild cognitive delay and three times more likely to have severe cognitive delay than were infants who were never treated with steroids, Dr. T. Flint Porter said at a perinatal conference sponsored by the University of California, Irvine.

The Utah study, which assessed the infants with the Bayley Scales of Infant Development at 9, 18, and 30 months, also found that those who were exposed to multiple courses were three times more likely to have mild motor delay and 21/2 times more likely to exhibit signs of severe motor delay.

The infants in the study included 166 who were not treated prenatally with steroids, 340 who received a single course, and 119 who received at least two courses.

These data were a part of the evidence considered by the National Institutes of Health panel that last year advised against the use of multiple courses of prenatal steroids outside of research trials, said Dr. Porter of the department of maternal-fetal medicine at the University of Utah, Salt Lake City.

There is no recent information on how frequently obstetricians use multiple courses of steroids to treat threatened preterm labor, Dr. Porter commented.

He said that he agreed ...