Published online August 1, 2007
PEDIATRICS Vol. 120 No. 2 August 2007, pp. 450 (doi:10.1542/peds.2007-1125)

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LETTER TO THE EDITOR

Effects of Multiple Courses of Antenatal Betamethasone on the Auditory Brainstem Responses of Premature Infants

Michael W. Church, PhD
Departments of Obstetrics-Gynecology and Otolaryngology Head-Neck Surgery
Wayne State University School of Medicine
Detroit, MI 48201

To the Editor.—

I read with interest the recent article by Amin and Guillet¹ regarding the effects of multiple courses of antenatal betamethasone on the auditory brainstem response (ABR) in premature infants. We recently finished a multisite study on the same topic for the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Our study had findings similar to those reported by Amin and Guillet. Specifically, we found that multiple courses of antenatal betamethasone did not have a significant effect, either beneficial or harmful, on the ABR when the infants were tested at a gestational age of 35 weeks. We have some questions, however, for the authors about their article. Their answers will help us prepare our manuscript and clarify some issues for us and other readers of their article.

1. In their study, there was no significant effect of multiple courses of antenatal betamethasone on birth weight. In contrast, in our study, we found significant reductions in birth weight, birth length, and head circumference. This suggests that our infants were exposed to more betamethasone than the infants in the Amin and Guillet study. The pregnant women in our multiple antenatal betamethasone treatment group were exposed to a median of 5 (range: 2–9) weekly courses of betamethasone; each course was comprised of 2 intramuscular injections of 12 mg of betamethasone given 24 hours apart. The Amin and Guillet article mentioned that their multiple-course groups had 2 courses. This is rather vague, and we would like more precise information. Specifically, what was the average or median number of betamethasone courses given to the pregnant women in their multiple-course betamethasone groups (groups II and IIb)?
   
2. We calculated ABR I–V interpeak latencies by using the mean wave I and wave V latencies provided in their Table 2. For the no-steroid group and groups I, II, and IIb, we calculated the I–V interpeak latencies to be 6.60, 6.56, 6.35, and 6.55 milliseconds, respectively. These values are quite different from the 6.27, 5.84, 6.19, and 6.30 milliseconds values given at the bottom of that table. Why the differences?
   
3. The Amin and Guillet article in Pediatrics seems very similar to their previous publication in Journal of Perinatology.² Both publications have the same Fig 1, seemingly described recruitment of mother-infant pairs from the same hospital with overlapping recruitment dates, and described the same methodology. With these issues in mind, what is the extent of the overlap between the 2 studies? Do the 2 studies have mutually exclusive patient populations, or do they overlap? Was the present study a reanalysis of their previously published data, or are these totally new data?
   

REFERENCES

1. Amin SB, Guillet R. Auditory neural maturation after exposure to multiple courses of antenatal betamethasone in premature infants as evaluated by auditory brainstem response. Pediatrics. 2007;119 :502 –508[Abstract/Free Full Text]
2. Amin SB, Orlando MS, Dalzell LE, Merle KS, Guillet R. Brainstem maturation after antenatal steroids exposure in premature infants as evaluated by auditory brainstem-evoked response. J Perinatol. 2003;23 :307 –311[CrossRef][Medline]

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PEDIATRICS (ISSN 1098-4275). ©2007 by the American Academy of Pediatrics

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This Article Extract Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Request Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Church, M. W. Search for Related Content PubMed PubMed Citation Articles by Church, M. W. Related Collections Premature & Newborn Social Bookmarking                         What's this?