In Reply.—

We thank Dr Gordon for his comments on our study. He asks whether antenatal glucocorticoids might also act synergistically to increase the risk for gastrointestinal perforation and whether late administration of betamethasone might have contributed to “supraphysiologic cortisol levels.” We take this opportunity to present additional data regarding these 2 issues. First, those infants exposed to prenatal steroids were less likely, rather than more likely, to experience gastrointestinal perforation (4.6% vs 10.5%). The result was not statistically significant in our cohort of 360 infants (P = .06), and prenatal steroid administration was not randomized; however, these data make it unlikely that prenatal glucocorticoids act synergistically in the clinical setting to promote perforation.

Regarding the relationship of prenatal glucocorticoid dosing to cortisol concentrations, we found that infants exposed to prenatal glucocorticoids had significantly lower baseline cortisol values (P = .001). For those infants exposed to...

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