Antenatal corticosteroids and neurodevelopmental outcomes in late preterm births

Area of Science:

• Neonatal Medicine
• Pediatric Neurology
• Public Health

Background:

• Antenatal corticosteroids (ACS) are crucial for reducing mortality and morbidity in preterm neonates.
• Concerns exist regarding the long-term safety of ACS, particularly in late preterm (LPT) infants (34-36 weeks gestation).
• The subtle benefits of ACS in LPT infants warrant investigation into potential subtle long-term adverse effects.

Purpose of the Study:

• To investigate the long-term safety of antenatal corticosteroids (ACS) in infants born during the late preterm (LPT) period.
• To assess the association between early ACS exposure and neurocognitive, audiometry, and visual testing by 5 years of age.

Main Methods:

• Population-based, retrospective cohort study in Ontario, Canada (2006-2011).
• Included singleton infants born between 34^0/7 and 36^6/7 weeks gestation with at least 5 years of follow-up.
• Analyzed exposure to ACS prior to 34^0/7 weeks gestation and outcomes including suspected neurocognitive disorder, and audiometry/visual testing.

Main Results:

• 25,668 infants were analyzed; 10.5% received ACS.
• Infants exposed to ACS had lower birth weight and higher rates of neonatal interventions.
• ACS exposure was associated with increased risk of suspected neurocognitive disorder (aHR 1.12), audiometry testing (aHR 1.20), and visual testing (aHR 1.06) by age 5.

Conclusions:

• Exposure to antenatal corticosteroids before 34 weeks gestation in late preterm infants is linked to increased healthcare utilization for neurocognitive, auditory, and visual assessments by age 5.
• These findings highlight potential long-term safety considerations for ACS use in the late preterm period.