{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T06:39:04Z","timestamp":1781937544782,"version":"3.54.5"},"reference-count":33,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2008,2,1]]},"abstract":"<jats:p>OBJECTIVE. We compared the development of adverse neurodevelopmental outcomes at corrected ages of 18 to 22 months for extremely low birth weight infants exposed prenatally to dexamethasone, betamethasone, or no steroid.<\/jats:p><jats:p>METHODS. Study infants were extremely low birth weight (401\u20131000 g) infants who were in the care of National Institute of Child Health and Human Development Neonatal Research Network centers between January 1, 2002, and April 30, 2003; they were assessed neurodevelopmentally at corrected ages of 18 to 22 months. Outcomes were defined as Bayley Scales of Infant Development-II Mental Development Index of &amp;lt;70, Bayley Scales of Infant Development-II Psychomotor Development Index of &amp;lt;70, bilateral blindness, bilateral hearing aid use, cerebral palsy, and neurodevelopmental impairment. Neurodevelopmental impairment was defined as \u22651 of the aforementioned outcomes.<\/jats:p><jats:p>RESULTS. A total of 1124 infants met entry criteria. There were no statistically significant associations between prenatal dexamethasone exposure and any follow-up outcome, compared with no prenatal steroid exposure. Prenatal betamethasone exposure was associated with reduced risks of hearing impairment and neurodevelopmental impairment and with increased likelihood of unimpaired status, compared with no prenatal steroid exposure. Compared with betamethasone, dexamethasone was associated with a trend for increased risk of Psychomotor Development Index of &amp;lt;70, increased risk of hearing impairment, and decreased likelihood of unimpaired status.<\/jats:p><jats:p>CONCLUSIONS. Prenatal betamethasone exposure was associated with increased likelihood of unimpaired neurodevelopmental status and reduced risk of hearing impairment at corrected ages of 18 to 22 months among extremely low birth weight infants, compared with prenatal dexamethasone exposure or no prenatal steroid exposure. Pending a randomized, clinical trial, it may be in the best interests of infants to receive betamethasone, rather than dexamethasone, when possible.<\/jats:p>","DOI":"10.1542\/peds.2007-1103","type":"journal-article","created":{"date-parts":[[2008,2,1]],"date-time":"2008-02-01T18:40:00Z","timestamp":1201891200000},"page":"289-296","source":"Crossref","is-referenced-by-count":79,"title":["Neurodevelopmental Outcomes of Extremely Low Birth Weight Infants Exposed Prenatally to Dexamethasone Versus Betamethasone"],"prefix":"10.1542","volume":"121","author":[{"given":"Ben H.","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Emory University School of Medicine, Atlanta, Georgia"},{"name":"MidAtlantic Neonatology Associates, Morristown, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara J.","family":"Stoll","sequence":"additional","affiliation":[{"name":"Division of Neonatal-Perinatal Medicine, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott A.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Research Triangle Institute, Research Triangle Park, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary D.","family":"Higgins","sequence":"additional","affiliation":[{"name":"National Institute of Child Health and Human Development, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the National Institute of Child Health and Human Development Neonatal Research Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2008,2,1]]},"reference":[{"key":"2021120820180399500_R1","doi-asserted-by":"crossref","unstructured":"Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics.\u20081972;50(4):515\u2013525","DOI":"10.1542\/peds.50.4.515"},{"key":"2021120820180399500_R2","doi-asserted-by":"crossref","unstructured":"Shankaran S, Bauer CR, Bain R, Wright LL, Zachary J. Relationship between antenatal steroid administration and grades III and IV intracranial hemorrhage in low birth weight infants: the NICHD Neonatal Research Network. Am J Obstet Gynecol.\u20081995;173(1):305\u2013312","DOI":"10.1016\/0002-9378(95)90219-8"},{"key":"2021120820180399500_R3","doi-asserted-by":"crossref","unstructured":"Wright LL, Verter J, Younes N, et al. Antenatal corticosteroid administration and neonatal outcome in very low birth weight infants: the NICHD Neonatal Research Network. 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Antenatal glucocorticoid treatment and cystic periventricular leukomalacia in very premature infants. N Engl J Med.\u20081999;341(16):1190\u20131196","DOI":"10.1056\/NEJM199910143411604"},{"key":"2021120820180399500_R8","doi-asserted-by":"crossref","unstructured":"Rayburn WF, Christensen HD, Gonzalez CL. A placebo-controlled comparison between betamethasone and dexamethasone for fetal maturation: differences in neurobehavioral development of mice offspring. Am J Obstet Gynecol.\u20081997;176(4):842\u2013850","DOI":"10.1016\/S0002-9378(97)70609-4"},{"key":"2021120820180399500_R9","doi-asserted-by":"crossref","unstructured":"Spinillo A, Viazzo F, Colleoni R, Chiara A, Maria Cerbo R, Fazzi E. Two-year infant neurodevelopmental outcome after single or multiple antenatal courses of corticosteroids to prevent complications of prematurity. Am J Obstet Gynecol.\u20082004;191(1):217\u2013224","DOI":"10.1016\/j.ajog.2003.12.023"},{"key":"2021120820180399500_R10","doi-asserted-by":"crossref","unstructured":"Lee BH, Stoll BJ, McDonald SA, Higgins RD. Adverse neonatal outcomes associated with antenatal dexamethasone versus antenatal betamethasone. Pediatrics.\u20082006;117(5):1503\u20131510","DOI":"10.1542\/peds.2005-1749"},{"key":"2021120820180399500_R11","doi-asserted-by":"crossref","unstructured":"Hack M, Horbar JD, Malloy MH, Tyson JE, Wright E, Wright L. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Network. Pediatrics.\u20081991;87(5):587\u2013597","DOI":"10.1542\/peds.87.5.587"},{"key":"2021120820180399500_R12","doi-asserted-by":"crossref","unstructured":"Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1500 gm. 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