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Multiple Courses of Antenatal Corticosteroids for Preterm Birth Study (MACS)

Phase 4
Completed
Conditions
Pregnancies at Increased Risk of Preterm Birth
Registration Number
NCT00187382
Lead Sponsor
Sunnybrook Health Sciences Centre
Brief Summary

In women at 26 to 30 weeks gestation and who are risk for threatened early birth, who have not had their baby by 14 or more days after being given a single course of antenatal corticosteroids (ACS), do repeated courses of ACS every 14 days until 33 weeks' gestational age lower the risk of illness or death in babies compared to repeated courses of placebo. Children are assessed at 2 years and 5 years for neurodevelopmental impairment.

Detailed Description

In women at 26 to 30 weeks gestation, who are at increased risk for preterm birth and remain undelivered 14 or more days following a single course of antenatal corticosteroids (ACS), are multiple course of ACS every 14 days until 33 weeks effective in reducing the risk of perinatal or neonatal mortality or significant neonatal morbidity, compared to placebo.

18-24 Month Follow-up: Children (18-24 months corrected gestational age) are assessed with the Bayley Scales of Infant Development (Second Edition) to determine neurodevelopmental impairment.

5 Year Follow-up (MACS-5): Children are assessed using the Child Behaviour Checklist (1 1/2 - 5) and the Behaviour Rating Inventory of Executive Function (Preschool version) to determine neurocognitive function.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
1858
Inclusion Criteria
  • Women who have previously received one completed course of ACS, at least 14 days ago and continue to be at increased risk of preterm birth
  • Gestational age greater ≥ 26 weeks and gestational age < 31 weeks
Exclusion Criteria
  • Women requiring chronic doses of corticosteroids secondary to medical conditions
  • Women with a contraindication to corticosteroids
  • Women with clinical evidence of chorioamnionitis (temperature ≥ 38°c)
  • Known lethal congenital anomaly (e.g. anencephaly)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
MACS: Perinatal or neonatal mortality or serious neonatal morbidity
MACS-5: Mortality or survival with severe neuro-morbidities at 5 years of age
Secondary Outcome Measures
NameTimeMethod
MACS: Death or neurologic impairment at 2 years of age
MACS-5: Measures of growth and blood pressure assessed by clinical exam
MACS-5: At Canadian sites, abnormalities in intelligence and specific cognitive skills (WPPSI-III, Beery: VMI and PPVT-III)

Trial Locations

Locations (1)

Data Coordinating Centre, CMICR 790 Bay Street, 7th Floor

🇨🇦

Toronto, Ontario, Canada

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