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Published on: June 24, 2020

Antenatal corticosteroids: a risk factor for the development of chronic disease

Elizabeth Asztalos1

  • 1Department of Paediatrics, University of Toronto and The Centre for Mother, Infant, and Child Research, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada M4N 3M5.

Journal of Nutrition and Metabolism
|April 24, 2012
PubMed

Insights

Antenatal corticosteroids (ACS) given during pregnancy to promote fetal lung maturity may lead to lower birth weight and long-term health issues. Research is exploring the lasting effects of ACS on fetal development and adult health outcomes.

Area of Science:

  • Perinatology
  • Developmental programming
  • Endocrinology

Background:

  • Preterm birth is a significant global health concern.
  • Antenatal corticosteroids (ACS) are used to accelerate fetal lung maturity in at-risk pregnancies.
  • Repeated courses of ACS are increasingly administered for ongoing preterm birth risk.

Purpose of the Study:

  • To investigate the potential long-term consequences of exogenous ACS exposure on fetal development.
  • To examine the association between ACS administration and adverse adult health outcomes.
  • To explore the impact of ACS on the hypothalamic-pituitary-adrenal (HPA) axis and neurological function.

Main Methods:

  • Review of existing animal studies on ACS effects on HPA axis and neurological function.
  • Analysis of human studies examining developmental programming related to ACS exposure.
  • Correlation of birth weight changes with adult chronic illnesses and behavioral patterns.

Main Results:

  • Animal studies indicate that ACS exposure can cause permanent alterations in fetal HPA axis development.
  • Reduced birth weight following ACS exposure is linked to increased risks of coronary heart disease, stroke, hypertension, and type 2 diabetes in adulthood.
  • Evidence suggests potential lifelong changes in HPA axis activity and neurological function due to ACS.

Conclusions:

  • Exogenous ACS, while beneficial for fetal lung maturity, may have lasting adverse effects on development.
  • Further human studies are crucial to confirm the link between in-utero ACS exposure and long-term health programming.
  • Understanding these developmental impacts is essential for optimizing antenatal corticosteroid use in high-risk pregnancies.

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