Related Experiment Video
Updated: Jul 12, 2025
Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
Published on: June 13, 2021
Neurodevelopmental Outcomes Among Offspring Exposed to Corticosteroid and B2-Adrenergic Agonists In Utero
Abir Nagata1,2, Toshio Masumoto3, Hidekazu Nishigori4
1Department of Regenerative Dermatology, Graduate School of Medicine, Osaka University, Osaka, Japan.
Insights
In utero exposure to corticosteroids and β2-adrenergic agonists during pregnancy did not show an association with offspring neurodevelopmental delays. These asthma medications appear safe for both pregnant individuals and their children
Area of Science:
- Reproductive medicine and developmental pediatrics
- Pharmacology and teratology
- Public health and epidemiology
Background:
- Corticosteroids and β2-adrenergic agonists are frequently prescribed for asthma management in pregnant individuals.
- The impact of prenatal exposure to these medications on offspring neurodevelopment remains incompletely understood.
Purpose of the Study:
- To examine the relationship between the timing of in utero exposure to corticosteroids and β2-adrenergic agonists and neurodevelopmental milestones in children up to three years of age.
Main Methods:
- A large cohort study utilizing data from the Japan Environment and Children's Study (JECS).
- Inclusion of 91,460 mother-offspring pairs.
- Assessment of offspring neurodevelopment (communication, motor skills, problem-solving, personal-social skills) using the Ages and Stages Questionnaires (ASQ-3) at multiple time points from 6 to 36 months.
Main Results:
- No significant association was observed between prenatal corticosteroid exposure (early, mid-to-late, or throughout pregnancy) and any of the five assessed neurodevelopmental milestones.
- No association was found between early pregnancy β2-adrenergic agonist exposure and neurodevelopmental outcomes.
- A marginal association was noted between mid-to-late pregnancy β2-adrenergic agonist exposure and delayed personal-social skills (aOR, 1.48; 95% CI, 1.01-2.32).
Conclusions:
- The study suggests that prenatal exposure to corticosteroids and β2-adrenergic agonists, regardless of exposure timing, is not associated with adverse neurodevelopmental outcomes in offspring.
- Findings support the safety of these commonly used asthma medications during pregnancy for both maternal and child health.
- Further research with larger sample sizes may be warranted to confirm the observed marginal association with personal-social skills.
Importance:
Corticosteroids and β2-adrenergic agonists are commonly used during pregnancy to treat asthma. However, offspring neurodevelopmental outcomes following in utero exposure to these medications remain unclear.
Objective:
To investigate the association between timing of in utero exposure to corticosteroids and β2-adrenergic agonists and offspring neurodevelopmental milestones during the first 3 years of life.
Design, Setting, And Participants:
This cohort study obtained data from the Japan Environment and Children's Study, an ongoing birth cohort study conducted in collaboration with 15 Regional Centers across Japan. Participants were mother-offspring pairs who were recruited between January 1, 2011, and March 31, 2014. Data were analyzed between January and February 2023.
Exposure:
Corticosteroids and β2-adrenergic agonists were the exposure of interest. Timing of corticosteroid and β2-adrenergic agonist exposure included early pregnancy (weeks 0-12), mid- to late pregnancy (weeks >12), and both stages of pregnancy.
Main Outcomes And Measures:
Offspring neurodevelopmental milestones (communication, gross motor, fine motor, problem-solving, and personal-social skills) were assessed using the Japanese version of the Ages and Stages Questionnaires, 3rd edition, at 6, 12, 18, 24, 30, and 36 months.
Results:
In total, 91 460 mother-offspring pairs were analyzed. Among mothers, the mean (SD) age at delivery was 31.20 (5.05) years. Among offspring, 46 596 (50.9%) were males and 44 864 (49.1%) were females, of whom 66.4% had a gestational age of 39 to 41 weeks. During early, mid- to late, and both stages of pregnancy, 401 (0.4%), 935 (1.0%), and 568 (0.6%) offspring, respectively, were exposed to corticosteroids, whereas 170 (0.2%), 394 (0.4%), and 184 (0.2%), respectively, were exposed to β2-adrenergic agonists. No association of corticosteroid exposure during early, mid- to late, and both stages of pregnancy with all 5 neurodevelopmental milestones was found. Similarly, no association between β2-adrenergic agonist use during early pregnancy and all 5 neurodevelopmental milestones was observed. An association was found between β2-adrenergic agonist exposure during mid- to late pregnancy and delayed personal-social skills (adjusted odds ratio, 1.48; 95% CI, 1.01-2.32; P = .045).
Conclusions And Relevance:
Results of this study found no association between in utero corticosteroid and β2-adrenergic agonist exposure and offspring neurodevelopmental outcomes, regardless of the timing of exposure. Despite the limitations and low power of the study, the findings suggest that corticosteroids and β2-adrenergic agonists are safe for pregnant individuals with asthma and the neurodevelopment of their offspring.
More Related Videos
Related Concept Videos
01:07Teratogenicity
01:27Adrenal Gland Disorders
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
01:31Hormones of the Adrenal Glands
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
01:23Upper Respiratory Drugs: Antitussives, Expectorants, and Mucolytics
Antitussives include codeine, dextromethorphan (Robitussin), and benzonatate (Tessalon). Codeine and dextromethorphan exert their effects centrally by suppressing the cough reflex center in the medulla. Benzonatate operates peripherally within the respiratory tract by...
01:25Antiasthma Drugs: β2-Adrenoceptor Agonists
One class of bronchodilators includes β2-adrenoceptor agonists. These agents target the β2-adrenoceptors located on bronchial smooth muscle cells. By stimulating these receptors, β2-agonists induce...
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers