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Prenatal Betamethasone Exposure and its Impact on Pediatric Type 1 Diabetes Mellitus: A Preliminary Study in a
David Perna-Barrull1, Marta Murillo2, Nati Real2
1Immunology Service Germans Trias i Pujol Research Institute and University Hospital, Autonomous University of Barcelona, 08916 Badalona, Spain.
Insights
Prenatal betamethasone exposure did not increase type 1 diabetes (T1D) risk in children. This study suggests a potential trend towards decreased T1D incidence with betamethasone exposure, warranting further investigation.
Area of Science:
- Endocrinology
- Immunology
- Neonatology
Background:
- Betamethasone, a glucocorticoid, is used to mature fetal lungs in preterm delivery risks.
- Prenatal betamethasone exposure may influence immune system development and type 1 diabetes (T1D) incidence.
- Previous studies suggest betamethasone protects against experimental T1D in offspring.
Purpose of the Study:
- To investigate the association between prenatal betamethasone exposure and T1D incidence in humans.
- To evaluate if prenatal betamethasone exposure impacts T1D susceptibility in children.
Main Methods:
- A retrospective case-control study involving 945 children (471 with T1D, 474 healthy siblings).
- Data collected via parental questionnaires on gestational age, birth weight, and prenatal betamethasone exposure.
- Multiple logistic regression analysis used to determine the association between betamethasone exposure and T1D.
Main Results:
- No significant difference in T1D prevalence between children exposed (37.5%) and unexposed (49.52%) to prenatal betamethasone (p=0.139).
- A significantly higher percentage of T1D was observed in preterm infants exposed to betamethasone (18.05%) compared to controls (12.5%) (p=0.003).
- Univariate and multivariate logistic regression analyses did not show a significant association between betamethasone exposure and T1D risk.
Conclusions:
- Prenatal betamethasone exposure does not appear to increase T1D susceptibility in humans.
- Findings suggest a potential trend towards reduced T1D risk with prenatal betamethasone exposure.
- Further prospective studies are needed to confirm the effect of betamethasone on T1D risk.
Background:
Betamethasone, a glucocorticoid used to induce lung maturation when there is a risk of preterm delivery, can affect the immune system maturation and type 1 diabetes (T1D) incidence in the progeny. It has been described that prenatal betamethasone protects offspring from experimental T1D development. The main aim of this study was to evaluate the possible association between betamethasone prenatal exposure and T1D in humans. Research Design and Methods. A retrospective case-control study with a total of 945 children, including 471 patients with T1D and 474 healthy siblings, was performed. Participants were volunteers from the Germans Trias i Pujol Hospital and DiabetesCero Foundation. Parents of children enrolled in the study completed a questionnaire that included questions about weeks of gestation, preterm delivery risk, weight at birth, and prenatal betamethasone exposure of their children. Multiple logistic regression was used to detect the association between betamethasone exposure and T1D.
Results:
We compared T1D prevalence between subjects prenatally exposed or unexposed to betamethasone. The percent of children with T1D in the exposed group was 37.5% (21 of 56), and in the unexposed group was 49.52% (410 of 828) (p = 0.139). The percentage of betamethasone-treated subjects with T1D in the preterm group (18.05%, 13 of 72) was significantly higher than that found in the control group (12.5%, 9 of 72) (p = 0.003). The odds ratio for T1D associated with betamethasone in the univariate logistic regression was 0.59 (95% confidence interval, 0.33; 1.03 [p = 0.062]) and in the multivariate logistic regression was 0.83 (95% confidence interval, 0.45; 1.52 [p = 0.389]).
Conclusions:
The results demonstrate that the prenatal exposure to betamethasone does not increase T1D susceptibility, and may even be associated with a trend towards decreased risk of developing the disease. These preliminary findings require further prospective studies with clinical data to confirm betamethasone exposure effect on T1D risk.
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