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Impact of antenatal corticosteroid exposure on thymus size in premature infants

Hasan Kilicdag1, Birgin Torer2, Senay Demir3

  • 1Division of Neonatology, Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|November 12, 2021
PubMed

Insights

Antenatal corticosteroids (ACS) did not significantly alter the thymus/weight index (TWI) in premature infants. Thymic index (TI) was smaller in exposed infants, but TWI remained unchanged, indicating minimal long-term impact on thymus size relative to body weight.

Area of Science:

  • Neonatal Medicine
  • Pediatric Endocrinology
  • Immunology

Background:

  • Antenatal corticosteroids (ACS) are administered to mothers to promote fetal lung maturation.
  • Potential effects of ACS on the developing immune system, particularly the thymus, are not fully understood.
  • This study investigates the impact of ACS on thymus size in preterm neonates.

Purpose of the Study:

  • To examine the effect of antenatal corticosteroids (ACS) on the thymic index (TI) and thymus/weight index (TWI) in infants exposed to ACS.
  • To assess if ACS exposure influences thymus size in premature infants.

Main Methods:

  • Prospective study conducted from August 2014 to October 2018.
  • Thymus size was assessed using ultrasound on the second day of life.
  • Thymic index (TI) and thymus/weight index (TWI) were calculated to quantify thymus size.

Main Results:

  • 167 neonates (≤34 weeks gestation) were included: 94 exposed to ACS and 73 untreated.
  • ACS-exposed infants had significantly lower birth weight and length.
  • While thymic index (TI) was smaller in the ACS-exposed group, the thymus/weight index (TWI) showed no significant difference compared to the untreated group.

Conclusions:

  • Antenatal corticosteroid exposure did not significantly alter the thymus/weight index (TWI) in premature infants.
  • The findings suggest that relative thymus size, normalized for body weight, is not substantially affected by ACS.
  • Further research may explore long-term immunological consequences, if any.
Abstract

Keywords:
Antenatal corticosteroidsPreterm infantThymic indexThymic sizeThymus/weight index

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