Pulmonary Complications in a Birth Cohort after a Randomized Trial of Exposure to Antenatal Corticosteroids: the ALPS Follow-Up Study

Pulmonary Complications in a Birth Cohort after a Randomized Trial of Exposure to Antenatal Corticosteroids: the ALPS Follow-Up Study”, is a competitive renewal of the parent grants (U01 HL098554/HL098354). The study will follow the cohort enrolled in the ALPS trial. While most of the participants delivered in the late preterm period, approximately 20% of women delivered at term. We will keep investigators blinded as to the treatment group assignment of the cohort as we assess pulmonary function and asthma incidence in both exposure groups. The literature on the incidence of asthma by antenatal glucocorticoid exposure is limited in nature, with benefit, harm, and no difference found in the various available studies. There are no studies to address steroid exposure in the late preterm period, where pulmonary maturation remains an ongoing process. The ALPS study gives us the unique opportunity to leverage an existing birth cohort to assess long-term childhood consequences of late preterm exposure to antenatal corticosteroids. Thus, we hypothesize that there is pulmonary dysfunction as noted clinically by a diagnosis of chronic lung disease, including asthma, and measured objectively by impulse oscillometry and pulmonary function testing, that increases by decreasing gestational age at delivery. We further hypothesize that this increase is mitigated by exposure to antenatal betamethasone.