TY - JOUR
T1 - Maternal Side-Effects After Multiple Courses of Antenatal Corticosteroids (MACS)
T2 - The Three- Month Follow-Up of Women in the Randomized Controlled Trial of MACS for Preterm Birth Study
AU - for the MACS Collaborative Group
AU - Murphy, Kellie E.
AU - Hannah, Mary E.
AU - Willan, Andrew R.
AU - Ohlsson, Arne
AU - Kelly, Edmond N.
AU - Matthews, Stephen G.
AU - Saigal, Saroj
AU - Asztalos, Elizabeth
AU - Ross, Sue
AU - Delisle, Marie France
AU - Tomat, Laura
AU - Amankwah, Kofi
AU - Guselle, Patricia
AU - Gafni, Amiram
AU - Lee, Shoo K.
AU - Armson, B. Anthony
AU - Hewson, Sheila A.
AU - Rovet, Joanne
AU - Sananes, Renee
AU - Schmid, Isabelle
AU - Kwiatkowski, Leonardo
AU - Tortorella, Susana Marisa
AU - Bertin, Marta Susana
AU - Castaldi, José Luis
AU - Deguer, Carlos
AU - Klun, Milton
AU - Besegato, Cintia
AU - Izbizky, Gustavo
AU - Vaneri, Maria Cristina
AU - Fustinana, Carlos Alberto
AU - Otano, Lucas
AU - Palermo, Mario S.F.
AU - Murua, Emerson Javier
AU - Valera, Dolores Montes
AU - Sampietro, Hector
AU - Monaco, Antonio
AU - Savransky, Argentina Ricardo
AU - Dunaiewsky, Armando
AU - Basualdo, Maria Natalia
AU - Andina, Elsa
AU - Di Marco, Ingrid
AU - Rivero, Mabel
AU - Feu, Maria Celeste
AU - Garcia, Sergio
AU - Aguirre, Jesus Daniel
AU - Morales, Elba Mirta
AU - Ayala, Liana Elisa
AU - De Sagastizabal, Maria Teresa
AU - Abreo, Griselda
AU - Mankuta, David
N1 - Publisher Copyright:
© 2011 Society of Obstetricians and Gynaecologists of Canada.
PY - 2011/1/1
Y1 - 2011/1/1
N2 - Objective: A single course of antenatal corticosteroids (ACS) is associated with a reduction in respiratory distress syndrome and neonatal death. Multiple Courses of Antenatal Corticosteroids Study (MACS), a study involving 1858 women, was a multicentre randomized placebo-controlled trial of multiple courses of ACS, given every 14 days until 33+6 weeks or birth, whichever came first. The primary outcome of the study, a composite of neonatal mortality and morbidity, was similar for the multiple ACS and placebo groups (12.9% vs. 12.5%), but infants exposed to multiple courses of ACS weighed less, were shorter, and had smaller head circumferences. Thus for women who remain at increased risk of preterm birth, multiple courses of ACS (every 14 days) are not recommended. Chronic use of corticosteroids is associated with numerous side effects including weight gain and depression The aim of this postpartum assessment was to ascertain if multiple courses of ACS were associated with maternal side effects. Methods: Three months postpartum, women who participated in MACS were asked to complete a structured questionnaire that asked about maternal side effects of corticosteroid use during MACS and included the Edinburgh Postnatal Depression Scale Women were also asked to evaluate their study participation. Results: Of the 1858 women randomized, 1712 (92.1%) completed the postpartum questionnaire. There were no significant differences in the risk of maternal side effects between the two groups. Large numbers of women met the criteria for postpartum depression (14.1% in the ACS vs. 16.0% in the placebo group). Most women (94.1%) responded that they would participate in the trial again. Conclusion: In pregnancy, corticosteroids are given to women for fetal lung maturation and for the treatment of various maternal diseases. In this international multicentre randomized controlled trial, multiple courses of ACS (every 14 days) were not associated with maternal side effects, and the majority of women responded that they would participate in such a study again.
AB - Objective: A single course of antenatal corticosteroids (ACS) is associated with a reduction in respiratory distress syndrome and neonatal death. Multiple Courses of Antenatal Corticosteroids Study (MACS), a study involving 1858 women, was a multicentre randomized placebo-controlled trial of multiple courses of ACS, given every 14 days until 33+6 weeks or birth, whichever came first. The primary outcome of the study, a composite of neonatal mortality and morbidity, was similar for the multiple ACS and placebo groups (12.9% vs. 12.5%), but infants exposed to multiple courses of ACS weighed less, were shorter, and had smaller head circumferences. Thus for women who remain at increased risk of preterm birth, multiple courses of ACS (every 14 days) are not recommended. Chronic use of corticosteroids is associated with numerous side effects including weight gain and depression The aim of this postpartum assessment was to ascertain if multiple courses of ACS were associated with maternal side effects. Methods: Three months postpartum, women who participated in MACS were asked to complete a structured questionnaire that asked about maternal side effects of corticosteroid use during MACS and included the Edinburgh Postnatal Depression Scale Women were also asked to evaluate their study participation. Results: Of the 1858 women randomized, 1712 (92.1%) completed the postpartum questionnaire. There were no significant differences in the risk of maternal side effects between the two groups. Large numbers of women met the criteria for postpartum depression (14.1% in the ACS vs. 16.0% in the placebo group). Most women (94.1%) responded that they would participate in the trial again. Conclusion: In pregnancy, corticosteroids are given to women for fetal lung maturation and for the treatment of various maternal diseases. In this international multicentre randomized controlled trial, multiple courses of ACS (every 14 days) were not associated with maternal side effects, and the majority of women responded that they would participate in such a study again.
KW - Antenatal corticosteroids
KW - Postpartum depression
KW - Preterm birth
KW - Randomized controlled trial
UR - http://www.scopus.com/inward/record.url?scp=84867991467&partnerID=8YFLogxK
U2 - 10.1016/S1701-2163(16)35016-2
DO - 10.1016/S1701-2163(16)35016-2
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C2 - 21923988
AN - SCOPUS:84867991467
SN - 1701-2163
VL - 33
SP - 909
EP - 921
JO - Journal of Obstetrics and Gynaecology Canada
JF - Journal of Obstetrics and Gynaecology Canada
IS - 9
ER -