{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T11:15:06Z","timestamp":1787742906149,"version":"build-2784847793"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:p>Multiple courses versus a single course of antenatal corticosteroids (ACS) have been associated with mild respiratory benefits but also adverse outcomes like smaller head circumference and birth weight. Long-term effects warrant study. We systematically reviewed long-term outcomes (\u22651 year) in both preterm and term birth after exposure to preterm multiple courses (including a rescue dose or course) versus a single course. We searched seven databases from January 2000 to October 2021. We included follow-up studies of randomized controlled trials (RCTs) and cohort studies with births occurring in\/after the year 2000, given advances in perinatal care. Two reviewers assessed titles\/abstracts, articles, quality, and outcomes including psychological disorders, neurodevelopment, and anthropometry. Six follow-up studies of three RCTs and two cohort studies (over 2,860 children total) met inclusion criteria. Among children born preterm, randomization to multiple courses versus a single course of ACS was not associated with adjusted beneficial or adverse neurodevelopmental\/psychological or other outcomes, but data are scant after a rescue dose (120 and 139 children, respectively, low certainty) and nonexistent after a rescue course. For children born at term (i.e., 27% of the multiple courses of ACS 5-year follow-up study of 1,728 preterm\/term born children), preterm randomization to multiple courses (at least one additional course) versus a single course was significantly associated with elevated odds of neurosensory impairment (adjusted odds ratio\u2009=\u20093.70, 95% confidence interval: 1.57\u20138.75; 212 and 247 children, respectively, moderate certainty). In this systematic review of long-term outcomes after multiple courses versus a single course of ACS, there were no significant benefits or risks regarding neurodevelopment in children born preterm but little data after one rescue dose and none after a rescue course. However, multiple courses (i.e., at least one additional course) should be considered cautiously: after term birth, there are no long-term benefits but neurosensory harms.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/s-0042-1760386","type":"journal-article","created":{"date-parts":[[2023,2,2]],"date-time":"2023-02-02T00:02:25Z","timestamp":1675296145000},"page":"395-404","source":"Crossref","is-referenced-by-count":5,"title":["Long-Term Outcomes of Multiple versus a Single Course of Antenatal Steroids: A Systematic Review"],"prefix":"10.1055","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8085-6751","authenticated-orcid":false,"given":"Kiran","family":"Ninan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, McMaster University, Ontario, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, 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D.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, McMaster University, Ontario, Canada"},{"name":"Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada"},{"name":"Department of Radiology, McMaster University, Ontario, Canada"},{"name":"Division of Maternal-Fetal Medicine, McMaster University, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,2,1]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1097\/AOG.0000000000002237","article-title":"Committee opinion no. 713: antenatal corticosteroid therapy for fetal maturation","volume":"130","author":"Committee on Obstetric Practice","year":"2017","journal-title":"Obstet Gynecol"},{"key":"ref2","volume-title":"WHO Recommendations on Interventions to Improve Preterm Birth Outcomes","author":"World Health 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