Data access has been approved for a study aiming to provide high-quality evidence on the longer-term safety of antenatal corticosteroid administration for child neurodevelopment.
The project is being undertaken by Peter Socha, as part of his doctoral studies at McGill University. The project is supervised by Dr. Jennifer Hutcheon, Associate Professor in the Department of Obstetrics and Gynaecology at the University of British Columbia.
Randomized trials show that administering antenatal corticosteroids to pregnant women at risk of preterm labour reduces neonatal mortality and respiratory morbidity. As a result, Canadian and international practice guidelines advise that all eligible women at 26 to 34 weeks’ gestation should be given antenatal steroids.
There is, however, a lack in high quality evidence on the longer-term safety of antenatal corticosteroids according to Mr. Socha. “Select studies have indicated that antenatal steroids may have harmful consequences for child neurodevelopment, which has led some obstetrical leaders to advocate for more restricted use until long-term safety has been convincingly demonstrated,” he says.
Generating rigorous evidence on the effects of antenatal steroids for child neurodevelopment has been a challenge. Follow-up studies of randomized trials have been hampered by low follow-up rates and small sample sizes, and observational studies were susceptible to confounding.
Using data from a population-based cohort of preterm births in BC from an ongoing study lead by Professor Hutcheon, a regression discontinuity design was used to replicate the findings of randomized trials of antenatal corticosteroids on newborn respiratory morbidity. Having demonstrated the validity of the design in this context, this cohort can now be used to obtain unconfounded estimates of the effect of antenatal corticosteroids on longer-term child neurodevelopment.
By generating rigorous evidence on the association between antenatal corticosteroid administration and long-term child neurocognitive development, the study will support the optimal use of this treatment for both short and longer-term child health.
For the study, PopData will link Discharge Abstract Database, Medical Services Plan and mortality data from the BC Ministry of Health, with data from the BC Perinatal Data Registry.
The project is funded by the Canadian Institutes of Health Research (CIHR) and a Doctoral training award from the Fonds de recherche du Québec Santé (FRQS).
