BACKGROUND AND PURPOSE:

• Data is limited as to whether there are long-term effects of in-utero antenatal corticosteroid exposure on term-infants
• Osteen et al. (AJOG, 2022) assessed the long-term outcomes of term-born children at least 5 years of age who were exposed to antenatal corticosteroids in utero

METHODS:

• Retrospective cohort study
• Population
  • Children: Born ≥37 weeks and were ≥5 years at the start of the study
  • Mothers: Had threatened preterm labor during pregnancy
• Exposure
  • Exposure to antenatal corticosteroids
• Primary outcome
  • Diagnosis of asthma
  • Hypothesis for primary outcome: Antenatal corticosteroid exposure would be associated with adverse respiratory outcomes
• Secondary outcomes
  • Other childhood medical conditions

RESULTS:

• Exposed to antenatal corticosteroids: 629 | Unexposed: 2927
  • Women who received antenatal corticosteroids tended to have higher rates of maternal comorbidities (P≤0.01)
• There was no difference in the prevalence of asthma diagnoses between the groups (P=0.47)
  • Exposed: 12.6%
  • Unexposed: 11.6%
  • Adjusted odds ratio (aOR) 1.05 (95% CI, 0.79 to 1.39)
• There was no difference in prevalence of
  • Attention deficit disorder diagnoses (P=0.54)
  • Developmental delay (P=0.10)
• The odds of the child’s weight percentile being <10% was increased for antenatal corticosteroid-exposed children born at term
  • aOR 2.00 (95% CI, 1.22 to 3.25)

CONCLUSION:

• For term-born children exposed to antenatal corticosteroids, there was no difference in the prevalence of long-term childhood medical conditions such as asthma, ADD and developmental delay
• However, there may be increased odds of being in a lower growth percentile
• The authors state

…that providers should consider potential consequences to administering ACS and highlights further areas of research to determine which women diagnosed with threatened preterm labor are at the highest risk for delivery within 1-2 weeks

There may be a need for more judicious use of ACS in women who may not be likely to deliver until term

Learn More – Primary Sources:

Long-term childhood outcomes for babies born at term who were exposed to antenatal corticosteroids

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