A secondary analysis of the French EPIPAGE-2 cohort study, recently published in AJOG, assessed the impact of the delay between antenatal corticosteroid administration and birth on moderate or severe neurologic disabilities at 5 ½ years.

Among the 2613 children included in the study, whose mothers had received antenatal corticosteroid therapy to accelerate lung maturation, 71.9% were able to have a neurological assessment at the age of 5 ½ years.

Survival without moderate or severe neurologic disabilities was lower in children born more than 7 days after treatment, compared with those born between 48h and 7 days (ORa 0.70, IC95% 0.54-0.89).

The authors highlight a selection bias inherent in the long-term follow-up of EPIPAGE-2 children. The data available at 5 ½ years came from a population of patients with better socioeconomic status. This bias was taken into account by performing multiple imputation of the data as well as multivariate analysis.

The authors conclude that it is important to better target patients at risk of preterm birth, so that this treatment can be administered closer to birth, in order to increase its benefits.

Claire Guerini :
Thomas Schmitz :

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