Efficacy of antenatal corticosteroids on the lung function of premature children in Bangladesh: BILDing-ACTION (Bangladesh Infant Lung function and Diagnosis- Antenatal Corticosteroids for Improving Outcomes in Preterm Newborn)
Study period: January 2026- December 2029
Donor name: National Institute of Health (NIH), USA
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: Methods: In this prospective cohort study, we are following children whose mothers were previously enrolled in the ACTION-1 and ACTION-3 trials, which were conducted in Dhaka and Sylhet, and who delivered a baby at a gestational age <37 weeks. The total sample size is 521, including 176 babies from the ACTION-1 trial and 345 babies from the ACTION-3 trial. We are performing lung function tests using respiratory oscillometry and tidal breathing analysis once annually, with participants having 3 separate measurements throughout the study period. 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.
• Determine whether antenatal dexamethasone, versus placebo, improves lung function among premature 6-8 years-of-age 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 three years.
• Compare whether antenatal dexamethasone, versus placebo, reduces the cumulative incidence of digital stethoscope-confirmed lower respiratory illnesses among school-aged children born <34 weeks gestation and severe lower respiratory illnesses among late preterm infants in Bangladesh.