The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network Beneficial Effects of Antenatal Repeated Steroids study: impact of repeated doses of antenatal corticosteroids on placental growth and histologic findings

• Published in: American journal of obstetrics and gynecology 2007-09, Vol.197 (3), p.281.e1-281.e8
• Main Authors: Sawady, Joram, MD, Mercer, Brian M., MD, Wapner, Ronald J., MD, Zhao, Yuan, MSc, Sorokin, Yoram, MD, Johnson, Francee, RN, BSN, Dudley, Donald J., MD, Spong, Catherine Y., MD, Peaceman, Alan M., MD, Leveno, Kenneth J., MD, Harper, Margaret, MD, MS, Caritis, Steve N., MD, Miodovnik, Menachem, MD, Thorp, John M., MD, Ramin, Susan, MD, Carpenter, Marshall W., MD, Rouse, Dwight J., MD
• Format: Article
• Language: English
• Subjects: Adult; antenatal corticosteroid; Betamethasone - pharmacology; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; Dose-Response Relationship, Drug; Double-Blind Method; Female; Gestational Age; Glucocorticoids - pharmacology; Gynecology. Andrology. Obstetrics; histopathologic finding; Humans; Medical sciences; Obstetrics and Gynecology; Pharmacology. Drug treatments; placenta; Placenta - abnormalities; Placenta - drug effects; Placenta - pathology; Placentation; Pregnancy; Prenatal Injuries - chemically induced; preterm birth
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2007.06.041

Objective In utero exposure to repeated doses of antenatal corticosteroids (ACSs) has been shown to reduce fetal growth. Our goal was to evaluate whether weekly betamethasone (R-ACS) alters placental growth and histologic findings. Study Design In a multicenter randomized controlled trial of R-ACS vs a single course of ACS followed by weekly placebo (S-ACS), placentas were weighed after removal of the membranes and umbilical cord. A single pathologist who was masked to study group and pregnancy outcomes performed histologic evaluation for placental calcifications, infarction, fibrin deposition, and hemorrhage or thrombus formation, acute and chronic chorioamnionitis, fibromuscular vascular hyperplasia, nucleated red blood cells, and villous crowding, edema, fibrosis, or fibrinoid necrosis. Findings were compared between study groups and according to the number of courses of ACS. Results One hundred ninety-four placentas were available for evaluation. Univariable analyses revealed no differences between study groups in any of the 19 evaluated histologic parameters between R-ACS and S-ACS groups overall or in analyses that were restricted to deliveries at