Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
J Obstet Gynaecol Can. 2011 Sep;33(9):909-21.

Maternal side-effects after multiple courses of antenatal corticosteroids (MACS): the three-month follow-up of women in the randomized controlled trial of MACS for preterm birth study.

Collaborators (259)

Murphy KE, Amankwah K, Anthony Armson B, Asztalos E, Delisle M, Gafni A, Guselle P, Hannah ME, Hewson SA, Kelly EN, Lee SK, Matthews SG, Ohlsson A, Ross S, Rovet J, Saigal S, Sananes R, Schmid I, Willan AR, Kwiatkowski L, Tortorella SM, Blanca B, Susana Bertin M, Castaldi JL, Deguer C, Klun M, Besegato C, Izbizky G, Cristina Vaneri M, Alberto Fustinana C, Otano L, Palermo MS, Murua EJ, Montes Valera D, Sampietro H, Monaco A, Savransky R, Dunaiewsky A, Basualdo MN, Andina E, Di Marco I, Rivero M, Celeste Feu M, Garcia S, Daniel Aguirre J, Mirta Morales E, Ayala LE, Teresa De Sagastizabal M, Abreo G, Uranga A, de Lourdes Martin R, Arias C, del Estero S, Abalos Gorostiaga R, Curioni M, Alvarado J, Fuchtner C, Mostajo Flores D, Tonoli Tessari DM, Mauro Madi J, Roberto Soares de Lorenzi D, Mattana C, Brunstein C, Trapani A Jr, Schmaltz L, Ribero de Souza G, Elaine de Assis M, Melo Melgaco IA, Augusto Moreira de Sa R, Guerios Bornia R, Demianczuk NN, Penttinen E, Butt K, Hay K, Sandwich V, Armson BA, Vincer M, Allen V, Fanning C, Kulkarni R, Laplante J, Carson GD, Williams S, Holfeld S, Olatunbosun F, Dalton S, Henry A, Haughian J, Moutquin JM, Blouin D, Kocsis Bédard S, Sinai M, Murphy K, Ohlsson A, Kelly E, Jordan A, Shapiro J, Asztalos E, Barrett J, Cohen H, Andrews L, Owen H, Delisle MF, Popovska V, Soanes S, Helewa ME, Kenny D, del Rio S, Alto P, Gomez R, Silva K, Poblete JF, Ferrand P, Belmar C, Feng Su Q, Gu W, Liu ZW, Marrugo Flores M, Santoro CM, Ivan Ortiz E, Torres J, Rodriguez A, Hvidman L, Mouritzen A, Vikre-Jørgensen J, Hopp H, Nonnenmacher A, Braig U, Berg C, Bizjak G, Gembruch U, Schwarzer V, Klinikum H, Hoyme UB, Bittrich H, Oletzky B, Schneider J, Hollwitz B, Oehler K, Dressler F, Ertan AK, Hentschel J, Mack A, Schmidt W, Faber R, Kuhnert M, Stiller S, Kuschel B, Schneider KT, Zimmermann A, Krause M, Gröbe H, Terzioglu N, Seelbach-Goebel B, Falkert A, Mueller K, Voss H, Major T, Zoárd K, Bartha T, Bea P, Zsadányi J, Nachum Z, Peniakov M, Hallak M, Harlev A, Harel L, Chayen B, Siev S, Samberg I, Wolff L, Sadan O, Elyassi A, Baider C, Kohelet D, Golan A, Mankuta D, Bar-Oz B, Combs D, Rosen DJ, Kaneti HY, Tzachi T, Zausmer J, Tikva P, Maman M, Perri T, Taitelboum S, Simchen M, Shalev G, Goldinfeld M, Levine O, El-Zibdeh MY, Al-Faris LT, Ayyash HA, Saona Ugarte P, Preis K, Domzalska-Popadiuk I, Swiatkowska-Freund M, Janczewska I, Wilczynski J, Krekora M, Kesiak M, Gulczyńska E, Ropacka M, Madejczyk M, Rozycka J, Breborowicz GH, Szymankiewicz M, Borzova N, Posiseeva LV, Khodjaeva Z, Vikhlyaeva E, Palacio M, Salvia D, Botet F, Massanes M, Lopez M, Hösli I, Holzgreve W, Voekt CA, Belhia F, Hohlfeld P, Prince E, Beinder E, Mandach Uv, Fauchere JC, Roumen FJ, Pieters M, Smits F, Bolaji II, Adiotomre P, Al-Taher H, Barnes H, Abdul- Kadir R, Chi C, Van Someren V, Dexter S, Samelson R, Horgan MJ, Valentini C, Pardanani S, Bebbington M, Chazotte C, Kilpatrick S, Drahos JL, Saldana L, Mount B, Warner B, Wedig K, Lysikiewicz A, Bsat F, Fleming J, Lee A, Hoffman D, Bracken M, Crowley P, Donner A, Duley L, Tys J.

Author information

  • 1Department of Obstetrics and Gynaecology, Mount Sinai Hospital, University of Toronto, Toronto ON.

Abstract

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.

PMID:
21923988
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Loading ...
    Write to the Help Desk