***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND The efficacy and safety of repeat doses of prenatal corticosteroids remains uncertain . Our aim was to establish whether repeat prenatal corticosteroids given to women at risk of preterm birth can reduce neonatal morbidity without harm . METHODS In this hospital-based study , 982 women who remained at risk of preterm birth at less than 32 weeks ' gestation , 7 or more days after receiving a first course of prenatal corticosteroids  , were r and omly assigned to receive a repeat intramuscular dose of either 11.4 mg betamethasone ( as Celestone Chronodose ) , or saline placebo . This was repeated every week the woman remained undelivered , at less than 32 weeks ' gestation , and at risk of preterm birth . Primary outcomes were occurrence and severity of neonatal respiratory distress syndrome , use and duration of oxygen and mechanical ventilation , and weight , length , and head circumference at birth and hospital discharge . Statistical analyses were on an intention to treat basis . This study is registered as an International St and ard R and omised Controlled Trial , number IS RCT N48656428 . FINDINGS Fewer babies exposed to repeat corticosteroids had respiratory distress syndrome ( 33%vs 41 % ; relative risk 0.82 , 95 % CI 0.71 - 0.95 , p=0.01 ) and fewer had severe lung disease ( 12%vs 20 % ; relative risk 0.60 , 95 % CI 0.46 - 0.79 , p=0.0003 ) than those in the placebo group . In keeping with these benefits , babies exposed to repeat corticosteroids needed less oxygen therapy ( p=0.03 ) , and shorter duration of mechanical ventilation ( p=0.01 ) . Mean weight , length , and head circumference at birth and hospital discharge did not differ between treatment groups . Z-scores for weight ( p=0.04 ) and head circumference ( p=0.03 ) at birth were lower in the babies who received repeat corticosteroids although at the time of hospital discharge Z-scores did not differ between treatment groups ( p=0.29 for weight , p=0.48 for head circumference ) . INTERPRETATION Exposure to repeat doses of antenatal corticosteroids reduces neonatal morbidity . Pending long-term outcome results , the short-term benefits for the babies in our study support the use of repeat doses of corticosteroids in women who remain at risk of very preterm birth 7 or more days after an initial course The effect of periconceptional multivitamin supplementation on postnatal development was studied in a r and omised controlled trial comparing the use of a multivitamin tablet ( Elevit Pronatal ) with a tablet containing trace elements as part of the Hungarian Optimal Family Planning Programme . Of 4122 liveborn infants , 3356 were examined after the eighth month of life and medical records were obtained for a further 357 ; thus the total number of infants evaluated was 3713 ( 90.1 % ) . The mortality was not significantly different between the groups receiving the multivitamins ( 9.6/1000 ) and trace elements ( 7.1/1000 ) . There was no significant difference in the rates of serious or chronic disorders between the study groups except for atopic dermatitis , which was reported more often in the group receiving multivitamins ( 15 v four cases ) . Somatic development ( body weight , body length , and head circumference ) did not show a significant difference between the two groups . Mental and behavioural development was also similar in the two groups OBJECTIVE --To examine any associations between routine ultrasonography in utero and subsequent brain development as indicated by non-right h and edness at primary school age and neurological development during childhood . DESIGN --Follow up of 8 and 9 year old children of women who took part in two r and omised , controlled trials of routine ultrasonography during pregnancy . SETTING --Clinics of 60 general practitioners in Norway during 1979 - 81 . Maternal and child health centres . SUBJECTS--2161 ( 89 % ) of 2428 eligible singletons were followed up , partly through a question naire to their parents and partly through information from health centres . MAIN OUTCOME MEASURES --The dominant h and of the child was assessed by 10 questions . Deficits in attention , motor control , and perception were evaluated by five questions . Impaired neurological development during the first year of life was assessed by an abbreviated version of the Denver developmental screening test . RESULTS --The odds of non-right h and edness were higher among children who had been screened in utero than among control children ( odds ratio 1.32 ; 95 % confidence interval 1.02 to 1.71 ) . No clear differences were found between the groups with regard to deficits in attention , motor control , and perception or neurological development during the first year of life . CONCLUSION --Our data suggest a possible association between  routine ultrasonography  in utero and subsequent non-right h and edness , whereas no association with impaired neurological development was found . As the question on non-right h and edness was one of six initial hypotheses , the observed results may be due to chance . None the less , the results suggest that the hypothesis may have some merit and should be tested in future studies BACKGROUND Evidence suggests that asthma is rooted in the intrauterine environment and that intake of marine n-3 polyunsaturated fatty acids ( n-3 PUFAs ) in pregnancy may have immunomodulatory effects on the child . OBJECTIVE Our aim was to examine whether increasing maternal intake of n-3 PUFAs in pregnancy may affect offspring risk of asthma . DESIGN In 1990 , a population -based sample of 533 women with normal pregnancies were r and omly assigned 2:1:1 to receive four 1-g gelatin capsules/d with fish oil providing 2.7 g n-3 PUFAs ( n = 266 ) ; four 1-g , similar-looking capsules/d with olive oil ( n = 136 ) ; or no oil capsules ( n = 131 ) . Women were recruited and r and omly assigned around gestation week 30 and asked to take capsules until delivery . Among 531 live-born children , 528 were identified in registries and 523 were still alive by August 2006 .  Diagnoses from the International Coding of Diseases version 10 were extracted from a m and atory registry that recorded diagnoses reported from hospital contacts . RESULTS During the 16 y that passed since childbirth , 19 children from the fish oil  and  olive oil groups had received an asthma-related diagnosis ; 10 had received the diagnosis allergic asthma . The hazard rate of asthma was reduced by 63 % ( 95 % CI : 8 % , 85 % ; P = 0.03 ) , whereas the hazard rate of allergic asthma was reduced by 87 % ( 95 % CI : 40 % , 97 % ; P = 0.01 ) in the fish oil compared with the olive oil group . CONCLUSION Under the assumption that intake of olive oil in the dose provided here was inert , our results support that increasing n-3 PUFAs in late pregnancy may carry an important prophylactic potential in relation to offspring asthma BACKGROUND We previously reported that maternal micronutrient supplementation in rural Nepal decreased low birth weight by approximately 15 % . OBJECTIVE We examined the effect of daily maternal micronutrient supplementation on  fetal loss and infant mortality .  DESIGN The study was a double-blind , cluster-r and omized , controlled trial among 4926 pregnant women and their 4130 infants in rural Nepal . In addition to vitamin A ( 1000 microg retinol equivalents ) , the intervention groups received either folic acid ( FA ; 400 microg ) , FA + iron ( 60 mg ) , FA + iron + zinc ( 30 mg ) , or multiple micronutrients ( MNs ; the foregoing plus 10 microg vitamin D , 10 mg vitamin E , 1.6 mg thiamine , 1.8 mg riboflavin , 2.2 mg vitamin B-6 , 2.6 microg vitamin B-12 , 100 mg vitamin C , 64 microg vitamin K , 20 mg niacin , 2 mg Cu , and 100 mg Mg ) . The control group received vitamin A only . RESULTS None of the supplements reduced fetal loss . Compared with control infants , infants whose mothers received FA alone or with iron or iron + zinc had a consistent pattern of 15 - 20 % lower 3-mo mortality ; this pattern was not observed with MNs . The effect on mortality was restricted to preterm infants , among whom the relative risks ( RRs ) were 0.36 ( 95 % CI : 0.18 , 0.75 ) for FA , 0.53 ( 0.30 , 0.92 ) for FA + iron , 0.77 ( 0.45 , 1.32 ) for FA + iron + zinc , and 0.70 ( 0.41 , 1.17 ) for MNs . Among term infants , the RR for mortality was close to 1 for all supplements except MNs ( RR : 1.74 ; 95 % CI : 1.00 , 3.04 ) . CONCLUSIONS Maternal micronutrient supplementation failed to reduce overall fetal loss or early infant mortality .  Among preterm infants , FA alone or with iron reduced mortality in the first 3 mo of life . MNs may increase mortality risk among term infants , but this effect needs further evaluation BACKGROUND Maternal zinc supplementation has been suggested as a potential intervention to reduce the incidence of low birth weight in developing countries . To date , placebo-controlled trials have all been performed in industrialized countries and the results are inconsistent . OBJECTIVE The objective of this study was to evaluate whether zinc supplementation in Bangladeshi urban poor during the last 2 trimesters of pregnancy was associated with pregnancy outcome . DESIGN We conducted a double-blind , placebo-controlled trial in which 559 women from Dhaka slums , stratified by parity between 12 and 16 wk of gestation , were r and omly assigned to receive 30 mg elemental Zn/d ( n = 269 ) or placebo ( n = 290 ) . Supplementation continued until delivery .  Serum zinc was estimated at baseline and at 7 mo of gestation . Dietary intake was assessed at baseline and anthropometric measurements were made monthly . Weight , length , and gestational ages of 410 singleton newborns were measured within 72 h of birth . RESULTS At 7 mo of gestation , serum zinc concentrations tended to be higher in the zinc-supplemented group than in the placebo group ( 15.9 + /- 4.4 compared with 15.2 + /- 4.3 micromol/L ) . No significant effect of treatment was observed on infant birth weight ( 2513 + /- 390 compared with 2554 + /- 393 g ; NS ) or on gestational age , infant length , or head , chest , or midupper arm circumference . The incidence and distribution of low birth weight , prematurity , and smallness for gestational age also did not differ significantly after zinc supplementation . CONCLUSIONS Supplementation with 30 mg elemental Zn during the last 2 trimesters of pregnancy did not improve birth outcome in Bangladeshi urban poor . These results indicate that interventions with zinc supplementation alone are unlikely to reduce the incidence of low birth weight in Bangladesh BACKGROUND A negative effect of prenatal zinc deficiency on brain function has been well established in experimental animals , but this association in humans is controversial . OBJECTIVE We evaluated the effect of prenatal zinc supplementation on the mental and psychomotor development of 355 children whose mothers participated in a double-blind trial of zinc supplementation that result ed in increased head circumference and birth weight .  DESIGN The children took 6 tests-the Differential Ability Scales , Visual Sequential Memory , Auditory Sequential Memory , Knox Cube , Gross Motor Scale , and Grooved Pegboard tests-at a mean age of 5.3 y. The scores were compared between the children of women who received a daily oral dose of 25 mg Zn during the second half of pregnancy and the children of women who received placebo . RESULTS There were no differences in the test scores of neurologic development between the 2 groups . We analyzed the scores in 4 subgroups on the basis of maternal body mass index , because the increases in birth weight and head circumference due to the supplementation occurred only in the children of women with a body mass index ( in kg/m(2 ) ) < 26.0 in the original trial . No differences in the scores were found between these subgroups . CONCLUSIONS Zinc supplementation of women in the latter half of pregnancy had no effect on the neurologic development of their children at age 5 y. It is not known whether our findings of no positive effect in the population with apparently inadequate zinc nutriture can be readily extrapolated to other population BACKGROUND Iron deficiency anemia ( IDA ) is common in pregnant women , but previous trials aim ed at preventing IDA used high-dose iron supplements that are known to cause gastrointestinal side effects . OBJECTIVE The objective was to assess the effect on  maternal IDA and iron deficiency ( ID , without anemia ) of supplementing pregnant women with a low dosage (  
    Output:
    
Only a small minority of large perinatal RCTs report the long-term follow-up of the child .