Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial

Dalziel SR, Walker NK, Parag V, Harding JE, Robinson JS; ACTORDS Study Group

2005

New Zealand

The authors assessed whether antenatal exposure to betamethasone for the prevention of neonatal respiratory distress syndrome affects cardiovascular risk factors at 30 years of age. They followed up at age 30 years 534 individuals whose mothers participated in a double-blind, placebo-controlled, randomised trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome. Mothers received two doses of betamethasone or placebo given by intramuscular injection 24 h apart. Follow-up assessments included anthropometry; measurement of blood pressure, blood lipids (after overnight fasting), and early morning cortisol levels; and a 75 g oral glucose tolerance test. There were no differences between those exposed to betamethasone and to placebo in body size, blood lipids, blood pressure, plasma cortisol, prevalence of diabetes, or history of cardiovascular disease. After a 75 g oral glucose tolerance test, participants exposed to betamethasone had higher plasma insulin concentrations at 30 min (60�5 vs 52�0 mIU/L; ratio of geometric means 1�16 [95% CI 1�03 to 1�31], p=0�02) and lower glucose concentrations at 120 min (4�8 vs 5�1 mmol/L; difference

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