Projects Details

Study period: January 2025 to March 2027

Donor name: Thrasher Research Fund

Partners: Johns Hopkins School of Medicine, USA; Johns Hopkins Bloomberg School of Public Health, USA; University of Szeged, Hungary; University of Cape Town, South Africa.

Project Description:

Background: Preterm birth is a major global health concern, particularly in low-resource settings like South Asia and sub-Saharan Africa. Preterm infants are susceptible to lung injury, which can lead to chronic lung disease later in life. This study seeks to explore whether antenatal corticosteroid (ACS) can mitigate lung problems in these populations.

Objective:
   • Determine whether antenatal dexamethasone, versus placebo, improves lung function among premature 5-year-old children born <34 weeks’ gestation.
   • Determine if antenatal dexamethasone, compared to placebo, improves lung growth and development among late preterm infants (34 weeks to <37 weeks) over the first two years of life.
   • Compare lung function among premature 5-year-old children born <34 weeks’ gestation to age and 5-year-old children born at term (37 weeks or later).
   • Compare lung function among late preterm infants over the first two years of life to age and children born at term (37 weeks of later).

Methods: In this prospective cohort study, we are following children whose mothers were previously enrolled in the ACS trials, which were conducted in Dhaka and Sylhet, and who delivered baby at a gestational age <37 weeks. Additionally, we are recruiting term-born children of the same age groups as a comparison group. The total sample size is 696. We are performing lung function tests using respiratory oscillometry and tidal breathing analysis at 6 months, at 2 years and at 5 years. Primary outcomes include pre-bronchodilator mean resistance at 7 Hz (R7), mean Lung Clearance Index (LCI), and severe respiratory disease.

Significance: This study will provide critical data on whether antenatal corticosteroid therapy offers sustained pulmonary benefits in preterm infants from low-resource settings. Findings will inform global neonatal care policies and improve respiratory health outcomes for preterm infants both in Bangladesh and worldwide.