ANCHOR

The ANCHOR Study is a follow-up study investigating the long-term effects of antenatal corticosteroids.

What is the ANCHOR Study about?

The aim of the ANCHOR Study is to determine the long-term effects of
treatment before birth with a medicine called corticosteroids. We will
assess adults who received this treatment before birth as part of two
randomised trials.   

Background to the Study

The Auckland Steroid Study was the first randomised trial of antenatal corticosteroids to be undertaken in the world. When the mothers in the study were pregnant, there was a risk that they may give birth early (preterm). They received corticosteroids, or a matching placebo, before the birth. The study showed that corticosteroids reduced death and illness in their babies, and appeared to be safe in the short term. These “babies” were born between 1969 and 1974 and will now be around 50 years old.

The ACTORDS study was a multi-centre study undertaken at 23 centres across New Zealand and Australia between 1998 and 2004. Mothers who took part in this study had already received one course of corticosteroids, but were still at risk of preterm birth a week or more later. They were randomised to receive repeat corticosteroids or a placebo. That study showed that repeat corticosteroids further reduced the risk of lung disease and other serious illness in their babies and appeared to be safe up to 2 years and 6 - 8 years of age. These “babies” will now be around 20 years old.

The ANCHOR study is following up the children and grandchildren of women who took part in the Auckland Steroid Trial and the ACTORDS trial to determine what effect (if any) the treatment had on their health and well-being as an adult, as well as on the next generation.  

Why is the Study important?

Babies born early (preterm) often have trouble adjusting to life outside of the womb, as some of their major organs, especially their lungs, are not yet fully developed.

Although there is no doubt that giving corticosteroids to women at risk of preterm birth benefits their baby, we still don’t know if this has any effect on the later health of the “baby” as they get older. Some studies in animals have suggested that this is possible, and some suggest that it is possible that these effects may also be passed down to their children, but there are no long-term studies in people.

New information about the long-term effects, if any, of exposure to antenatal corticosteroids on the baby and their children, would provide important information about the safety of this effective and low-cost intervention. Understanding any possible effects on adult health will also help healthcare professionals decide how best to care for mothers and their babies as they grow up in the future.  

What is involved?

Participants will be asked to complete a questionnaire about health, wellbeing, education and employment, and to give permission for the researchers to access some information about them that has been routinely collected by New Zealand Government Agencies. They will also be asked if their children would be willing to do the same thing.  

We are currently contacting participants of the Auckland Steroid Trial and will then start contacting participants of the ACTORDS study. If you were in one of these studies previously and would like to be involved in the current stage of the research please get in touch with us for more information and to update your contact information via the email and phone number below. The impact of the study could be huge and will benefit the future of healthcare for mothers and babies all around the world. Watch the video below to find out more about how you can be a part of this ground-breaking study.  

Why are we doing it?

It is now standard practice around the world to give pregnant women at risk of preterm birth corticosteroids before their baby is born. However, there is considerable interest in finding out whether there are any long-term health effects for both the child and for the next generation.  

ANCHOR Study team contacts

For more information about the study, email the study team at
ANCHOR@auckland.ac.nz

Or call the ANCHOR study coordinator on 027 280 0160

Related publications

Liggins GC, Howie RN. A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics. 1972;50(4):515-525.

Dalziel SR, Walker NK, Parag V, Mantell C, Rea HH, Rodgers A, Harding JE. Cardiovascular risk factors after antenatal exposure to betamethasone: 30-year follow-up of a randomised controlled trial. Lancet. 2005;365(9474):1856-1862. DOI: 10.1016/s0140-6736(05)66617-2

Dalziel SR, Lim VK, Lambert A, McCarthy D, Parag V, Rodgers A, Harding JE. Antenatal exposure to betamethasone: psychological functioning and health related quality of life 31 years after inclusion in randomised controlled trial. BMJ. 2005;331(7518):665. DOI: 10.1136/bmj.38576.494363.e0

McGoldrick  E, Stewart  F, Parker  R, Dalziel  SR. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database of Systematic Reviews 2020, Issue 12. Art. No.: CD004454. DOI: 10.1002/14651858. CD004454.pub4.

Crowther CA, Haslam RR, Hiller JE, Doyle LW, Robinson JS. Neonatal respiratory distress syndrome after repeat exposure to antenatal corticosteroids: a randomised controlled trial. Lancet. 2006;367(9526):1913-1919. DOI: 10.1016/S0140-6736(06)68846-6

Crowther CA, Doyle LW, Haslam RR, Hiller JE, Harding JE, Robinson JS, for the ACTORDS Study Group. Outcomes at 2 years of age after repeat doses of antenatal corticosteroids. NEJM. 2007;357:1179-89.

Crowther CA, Anderson PJ, McKinlay CJ, Harding JE, Ashwood PJ, Haslam RR, Robinson JS, Doyle LW. Mid-childhood outcomes of repeat antenatal corticosteroids: A randomized controlled trial. Pediatrics. 2016;138(4): e20160947. DOI: 10.1542/peds.2016-0947

McKinlay CJD, Cutfield WS, Battin MR, Dalziel SR, Crowther CA, Harding JE on behalf of the ACTORDS Study Group. Cardiovascular risk factors in children after repeat doses of antenatal glucocorticoids: an RCT. Pediatrics. 2015;135: e405-415. DOI: 10.1542/peds.2014-2408