ACTORDS Trial

Question 1

What was the aim of the ACTORDS trial?

Answer 1

To establish whether repeat prenatal corticosteroids given to women at risk of PT can reduce neonatal morbidity without harm

Question 2

How many women were recruited into the ACTORDS trial?

What was the setting of the trial?

Answer 2

982 women

23 hospitals, Australia and NZ

Question 3

What were the inclusion criteria for the ACTORDS trial?

Answer 3

Remained at risk of PTB < 32/40

7 or more days after receiving first course of prenatal corticosteroids

Question 4

What were the two intervention groups in the ACTORDS trial?

Answer 4

• Betamethasone 11.4mg IM
• Saline placebo

Repeated every week until the woman delivered, at less than 32/40, and at risk of PTB

Question 5

What were the primary outcomes of the ACTORDS trial?

Answer 5

R - RDS: occurrence and severity
U - Use and duration of supplemental O2
M - Mechanical ventilation
W - Weight, length, HC at birth and hospital discharge

Question 6

What was the effect of repeat steroids on occurrence of RDS and severe lung disease

Answer 6

Statistically significant
Decrease
NNT 14 for both

For RDS: 33% in steroid group and 41% in placebo group, RR 0.82

Question 7

What was the effect of repeat steroids on CS?

Answer 7

Increased
RR 1.13
Statistically significant