TY  - JOUR
AB  - Background The WHO ACTION-I trial in 2020 demonstrated the short-term efficacy and safety of antenatal dexamethasone for women at risk of early preterm birth in low-resource settings. However, the long-term effects of antenatal corticosteroids remain unclear, and no long-term follow-up studies have been conducted in low-resource settings. This pilot study aimed to evaluate the feasibility of participant follow-up from the ACTION-I trial and generate preliminary data on child health outcomes to inform the design of a larger follow-up cohort study within the trial population. Methods A follow-up cohort study was conducted in Sylhet, Bangladesh, among children born to women enrolled in the ACTION-I trial at three hospitals. Eligible participants were 181 infants who had survived to 28 completed days after birth. The primary outcomes were participant follow-up rate and neurodevelopmental outcomes at 5 years? corrected age. Results Of the 181 eligible children, 160 (88%) were found and enrolled in this follow-up?78 from the dexamethasone group and 82 from the placebo group. Median Ages and Stages Questionnaire-Third Edition scores were similar between groups, except for a modest yet significant reduction in gross motor scores in the dexamethasone group (adjusted median difference: ?5; 95%CI ?8.7 to ?1.3). Neurodevelopmental difficulties, particularly in fine motor and problem-solving domains, were the most common, affecting 39% and 34% of children in the dexamethasone group, and 33% and 36% in the placebo group, respectively. Behavioural and emotional problems were less common, with no significant differences between groups. Conclusions Long-term follow-up of preterm infants in a low-resource setting is feasible. High retention rates, along with preliminary outcome estimates, provide a critical foundation for planning larger, more definitive cohort studies in similar settings. Furthermore, the high prevalence of neurodevelopmental difficulties in this population highlights the need for early childhood interventions and continued developmental surveillance.
AU  - Sultana, S
AU  - Jaben, IA
AU  - Farha, T
AU  - Roy, S
AU  - Ahmed, S
AU  - Homer, CSE
AU  - Baqui, AH
AU  - Vogel, JP
DA  - 2025/11/24
DO  - 10.1136/bmjpo-2025-003983
JO  - BMJ Paediatrics Open
PB  - BMJ PUBLISHING GROUP
PY  - 2025/11/24
TI  - Antenatal dexamethasone for preterm birth and long-term health outcomes in children: a pilot follow-up cohort study of ACTION-I trial participants in Sylhet, Bangladesh
VL  - 9
Y1  - 2025/11/24
Y2  - 2026/06/06
ER  -