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Neurodevelopmental disorders among term infants exposed to antenatal corticosteroids during pregnancy: a

Nir Melamed1, Elizabeth Asztalos2, Kellie Murphy3

  • 1Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada nir.melamed@sunnybrook.ca.

BMJ Open
|October 3, 2019
PubMed

Insights

Antenatal corticosteroids (ACS) exposure in term infants is associated with increased healthcare use for neurodevelopmental issues. This study found higher rates of neurocognitive and neurosensory disorders in ACS-exposed children.

Area of Science:

  • Perinatal medicine
  • Developmental pediatrics
  • Public health

Background:

  • Antenatal corticosteroids (ACS) are increasingly used to improve fetal lung maturity.
  • Long-term safety concerns regarding neurodevelopmental outcomes persist despite ACS benefits.

Purpose of the Study:

  • To assess the association between antenatal corticosteroid exposure and neurodevelopmental problems in term infants.
  • To compare the likelihood of neurodevelopmental issues in ACS-exposed versus non-exposed infants.

Main Methods:

  • Retrospective population-based cohort study of 529,205 live singleton term infants in Ontario, Canada (2006-2011).
  • Follow-up duration averaged 7.8 years.
  • Neurodevelopmental problems were identified using diagnostic codes for audiometry, visual testing, or suspected neurocognitive disorders.

Main Results:

  • Infants exposed to ACS showed a higher cumulative rate of neurodevelopmental problems by age 5 (61.7% vs 57.8%, p<0.001).
  • Increased healthcare utilization was observed for audiometry testing (15.3% vs 12.7%), visual testing (45.4% vs 43.5%), and suspected neurocognitive disorders (25.8% vs 21.6%) in the ACS-exposed group.
  • The number needed to harm for the composite outcome was 25, indicating a small but significant increase in risk.

Conclusions:

  • Exposure to antenatal corticosteroids in term infants is associated with increased healthcare utilization for suspected neurocognitive and neurosensory disorders in childhood.
  • These findings highlight a potential long-term neurodevelopmental consequence of ACS exposure.
  • Further research may be warranted to understand the mechanisms and implications of this association.
Abstract

Keywords:
antenatal corticosteroidsneurodevelopmentalneurosensoryterm

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