C*STEROID – Safely improving outcomes after planned caesarean section birth’

More than one in ten babies in Aotearoa New Zealand are born by a planned caesarean section. Caesarean section before labour has started poses some risk to babies, particularly a higher chance of needing short-term breathing support and neonatal unit admission.

Corticosteroid injections given to mothers before preterm birth reduce these breathing problems, improve neonatal and childhood health, and save babies’ lives. However, there is limited research to determine whether these injections before a caesarean section birth at or near term (at 35 to 39 weeks) have similar beneficial effects. Furthermore, it is possible that they may lower baby blood sugar levels, which has the potential to cause harm to babies’ development.

The C*STEROID Trial is an established, large, placebo-controlled, randomised trial across 25 hospitals in Aotearoa and Australia. It has been designed to reliably and conclusively assess the effects of corticosteroids prior to planned caesarean section at or near term on newborn and childhood health. The trial will include 2548 babies and their mothers. It will provide the first high-quality evidence on the balance between benefit and harm of corticosteroids in this setting. It will reliably inform future clinical practice in Aotearoa and globally. The trial timeline has been extended, and it is now expected to be completed in 2027. This Cure Kids grant will enable and support the final Aotearoa participants to join and contribute to this world-leading research.