Trial reportBMC pregnancy and childbirth2014
Association between gestational age at birth, antenatal corticosteroids, and outcomes at 5 years: multiple courses of antenatal corticosteroids for preterm birth study at 5 years of age (MACS-5).
Trial report in BMC pregnancy and childbirth, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00187382 (Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study), which is not on this map. Cited by 28 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS)
Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes.The Cochrane database of systematic reviews · 2022Pooled it
- Repeat doses of prenatal corticosteroids for women at risk of preterm birth for improving neonatal health outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- Association between timing of antenatal corticosteroid and developmental outcomes in children born late preterm by high-risk pregnancies.BMC pregnancy and childbirth · 2026Article
- Article
- The influence of antenatal betamethasone timing on neonatal outcome in late preterm infants: a single-center cohort study.Archives of gynecology and obstetrics · 2025Article
- Conserved DNA methylation signatures in the prefrontal cortex of female newborn and juvenile guinea pigs following antenatal betamethasone exposure.Journal of neuroendocrinology · 2025Article
- Personalized Antenatal Corticosteroid Therapy and Central Nervous System Development: Reflections on the Gold Standard of Fetomaternal Therapy.Diseases (Basel, Switzerland) · 2024Review
- Identification of a DNA methylation signature in whole blood of newborn guinea pigs and human neonates following antenatal betamethasone exposure.Translational psychiatry · 2024Article
- Antenatal steroids elicited neurodegenerative-associated transcriptional changes in the hippocampus of preterm fetal sheep independent of lung maturation.BMC medicine · 2024Article
- Article
- Timing of antenatal corticosteroids in relation to clinical indication.Archives of gynecology and obstetrics · 2022Article
- The variation of antenatal corticosteroids administration for the singleton preterm birth in China, 2017 to 2018.BMC pediatrics · 2022Observational
- Associations Between Maternal Antenatal Corticosteroid Treatment and Psychological Developmental and Neurosensory Disorders in Children.JAMA network open · 2022Article
- Antenatal Steroids and Cord Blood T-cell Glucocorticoid Receptor DNA Methylation and Exon 1 Splicing.Reproductive sciences (Thousand Oaks, Calif.) · 2022Article
- DNA methylome signatures of prenatal exposure to synthetic glucocorticoids in hippocampus and peripheral whole blood of female guinea pigs in early life.Translational psychiatry · 2021Article
- Article
- Optimizing antenatal corticosteroid therapy for improving outcome of premature infants.Pediatric research · 2019Article
- Neurodevelopmental disorders among term infants exposed to antenatal corticosteroids during pregnancy: a population-based study.BMJ open · 2019Article
- Glucocorticoids, antenatal corticosteroid therapy and fetal heart maturation.Journal of molecular endocrinology · 2018Review
- Maternal hormonal milieu influence on fetal brain development.Brain and behavior · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS) showed no benefit in the reduction of major neonatal mortality/morbidity or neurodevelopment at 2 and 5 years of age. Using the data from the randomized controlled trial and its follow-up, the aim of this study was to evaluate the association between gestational ages at birth in children exposed to single versus multiple courses of antenatal corticosteroid (ACS) therapy in utero and outcomes at 5 years of age.
methodA total of 1719 children, with the breakdown into groupings of <30, 30-36, and ≥ 37 weeks gestation at birth, contributed to the primary outcome: death or survival with a disability in one of the following domains: neuromotor, neurosensory, and neurobehavioral/emotional disability and were included in this analysis.
resultsGestational age at birth was strongly associated with the primary outcome, p < 0.001. Overall, the interaction between ACS groups and gestational age at birth was not significant, p = 0.064. Specifically, in the 2 preterm categories, there was no difference in the primary outcome between single vs. multiple ACS therapy. However, for infants born ≥37 weeks gestation, there was a statistically significant increase in the risk of the primary outcome in multiple ACS therapy, 48/213 (22.5%) compared to 38/249 (15.3%) in the single ACS therapy; OR = 1.69 [95% CI: 1.04, 2.77]; p = 0.037.
conclusionPreterm birth (<37 weeks gestation) remained the primary factor contributing to an adverse outcome regardless of the number of courses of ACS therapy. Children born ≥ 37 weeks and exposed to multiple ACS therapy may have an increased risk of neurodevelopmental/neurosensory impairment by 5 years of age. To optimize outcomes for infants/children, efforts in reducing the incidence of preterm birth should remain the primary focus in perinatal research.
trial registrationThis study has been registered at (identifier NCT00187382).
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