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Repeated course antenatal steroids, inflammation gene polymorphisms, and neurodevelopmental outcomes at age 2

Erin A S Clark1, Lisa Mele, Ronald J Wapner

  • 1Departments of Obstetrics and Gynecology at the University of Utah, Salt Lake City, UT 84132, USA. erin.clark@hsc.utah.edu

American Journal of Obstetrics and Gynecology
|May 3, 2011
PubMed

Insights

Repeated antenatal corticosteroids may mitigate neurodevelopmental delay risks linked to the IL-6 -174 GG genotype. This finding suggests a potential protective effect in infants with this genetic predisposition.

Area of Science:

  • Perinatology
  • Genetics
  • Neurodevelopmental Pediatrics

Background:

  • Antenatal corticosteroids are used to mature fetal lungs.
  • Repeated courses may increase risks for neurodevelopmental issues.
  • Inflammation gene polymorphisms are implicated in neurodevelopmental outcomes.

Purpose of the Study:

  • To investigate the interaction between repeated antenatal corticosteroid courses and inflammation gene polymorphisms.
  • To assess the impact on neurodevelopmental outcomes at 2 years of age.

Main Methods:

  • Nested case-control analysis within a randomized controlled trial.
  • Comparison of single vs. repeated antenatal corticosteroid courses.
  • Analysis of 4 inflammation gene polymorphisms in cases with neurodevelopmental delay versus controls.

Main Results:

  • A significant interaction was found between repeated corticosteroids and the interleukin (IL)-6 -174 genotype (P = .046).
  • The IL-6 -174 GG genotype was associated with increased neurodevelopmental delay risk in the single-course group (OR, 6.47).
  • Repeated antenatal corticosteroids abrogated this genotype-associated risk (OR, 1.30).

Conclusions:

  • Repeated-course antenatal steroids may reduce the risk of neurodevelopmental delay associated with the IL-6 -174 GG genotype.
  • This suggests a potential protective role of repeated antenatal corticosteroids in genetically susceptible infants.
Abstract

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