Childhood Pulmonary Outcomes After Late Preterm Antenatal Corticosteroids

Authors

• Cynthia Gyamfi-Bannerman
• Rebecca G Clifton
• Robert A Wise
• Alan T N Tita
• Jessica A de Voest
• Sharon A McGrath-Morrow
• Elizabeth C Matsui
• Sean C Blackwell
• Monica Longo
• Sabine Z Bousleiman
• Felecia Ortiz
• Sankaran Krishnan
• Dwight J Rouse
• Torri D Metz
• George R Saade
• Maged M Costantine
• Kent D Heyborne
• John M Thorp
• Kelly S Gibson
• Geeta K Swamy
• William A Grobman
• Yasser Y El-Sayed
• George A Macones
• Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network and the National Heart, Lung, and Blood Institute

Language

English

Publication Date

3-1-2026

Journal

Obstetrics & Gynecology

DOI

10.1097/AOG.0000000000006162

PMID

41570323

PMCID

PMC12962128

PubMedCentral® Posted Date

3-6-2026

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: To evaluate whether antenatal betamethasone affects childhood respiratory impairment.

Methods: This was a prospective follow-up study of children aged 6 years and older from parents in the ALPS (Antenatal Late Preterm Steroids) trial randomized to betamethasone or placebo from 34 0/7 to 36 6/7 weeks of gestation. Primary outcome composite included the following: 1) abnormal spirometry, forced expiratory volume in 1 second (FEV 1 ) below the lower limit of normal, FEV 1 /forced vital capacity (FVC) below the lower limit of normal, or FVC below the lower limit of normal, defined as below the 5th percentile by the Global Lung Initiative; 2) physician-diagnosed asthma and daily asthma medication; or 3) daily asthma medication use in the past year. Children whose parents were enrolled in a concurrent trial were recruited to provide a term reference cohort for lung function. Adjusted analyses were performed controlling for confounders.

Results: Of 2,831 ALPS children, 1,218 enrolled, and 1,194 (98.0%) completed spirometry. There were no differences in the primary outcome (35.3% betamethasone, 35.8% placebo; adjusted relative risk [RR] 1.02, 95% CI, 0.87-1.18) or its individual components, although ever-noting wheezing or whistling in the chest was less common (40.7% betamethasone, 45.5% placebo, adjusted RR 0.88, 95% CI, 0.77-0.996). Compared with 432 children from the term reference cohort, ALPS children had more wheezing with exercise in the past year (7.2% betamethasone vs 4.4% term control group, adjusted RR 1.77, 95% CI, 1.03-3.06; 8.8% placebo vs term control group, adjusted RR 2.09, 95% CI, 1.25-3.48).

Conclusion: Among children aged 6 years or older, late preterm antenatal exposure to betamethasone was associated with lower rates of wheezing or whistling in the chest but no differences in other respiratory outcomes.

Keywords

Humans, Betamethasone, Female, Child, Pregnancy, Male, Prospective Studies, Infant, Newborn, Follow-Up Studies, Glucocorticoids, Asthma, Spirometry, Vital Capacity, Forced Expiratory Volume, Prenatal Exposure Delayed Effects, Premature Birth

Published Open-Access

yes

Recommended Citation

Gyamfi-Bannerman, Cynthia; Clifton, Rebecca G; Wise, Robert A; et al., "Childhood Pulmonary Outcomes After Late Preterm Antenatal Corticosteroids" (2026). Faculty, Staff and Student Publications. 3875.
https://digitalcommons.library.tmc.edu/uthmed_docs/3875