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Antenatal steroid therapy for fetal lung maturation: is there an association with childhood asthma?

Jason D Pole1, Cameron A Mustard, Teresa To

  • 1Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada. j.pole@utoronto.ca

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|February 5, 2009
PubMed

Insights

Fetal exposure to corticosteroids during pregnancy may increase the risk of childhood asthma. This finding highlights potential risks associated with antenatal steroid therapy.

Area of Science:

  • Obstetrics and Gynecology
  • Pediatrics
  • Epidemiology

Background:

  • Antenatal corticosteroid use is common in high-risk pregnancies.
  • Potential long-term effects of antenatal corticosteroids on fetal development require investigation.

Purpose of the Study:

  • To determine if fetal exposure to corticosteroids during pregnancy is an independent risk factor for childhood asthma.
  • To investigate the association between antenatal corticosteroid exposure and the development of asthma in children aged 36 to 72 months.

Main Methods:

  • Population-based cohort study of 79,395 infants born in Nova Scotia between 1989 and 1998.
  • Linked health care utilization records were used to identify incident asthma cases.
  • Generalized Estimating Equations controlled for confounders to estimate the odds ratio of asthma associated with corticosteroid exposure.

Main Results:

  • Corticosteroid therapy during pregnancy increased threefold over the study period.
  • Exposure to corticosteroids in utero was associated with an increased risk of childhood asthma (adjusted odds ratio: 1.23, 95% CI: 1.06, 1.44).

Conclusions:

  • Antenatal steroid therapy appears to be an independent risk factor for asthma development between 36 and 72 months of age.
  • Further research is needed to determine optimal, minimal effective corticosteroid doses to mitigate childhood asthma risk.
Abstract

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