Antenatal Corticosteroids and Infectious Diseases Throughout Childhood

Area of Science:

• Obstetrics and Gynecology
• Neonatal Research
• Pediatric Infectious Diseases

Background:

• International guidelines recommend antenatal corticosteroids (ACS) for pregnancies at risk of preterm birth before 34 weeks' gestation.
• The long-term impact of ACS exposure on childhood and adult infection susceptibility remains largely unknown.

Purpose of the Study:

• To investigate the association between antenatal corticosteroid (ACS) exposure and the risk of respiratory and nonrespiratory infections in children.
• To compare infection susceptibility between ACS-exposed and unexposed children born at various gestational ages.

Main Methods:

• Population-based cohort study utilizing nationwide registries from Finland and Scotland (Consortium for the Study of Pregnancy Treatments).
• Included singleton births between 1997-2018 (Finland) and 2006-2018 (Scotland), followed until 2018.
• Outcomes included first diagnosis of respiratory or nonrespiratory infections, stratified by gestational age at birth.

Main Results:

• ACS exposure was associated with increased risks of respiratory and nonrespiratory infections in children born full-term (37-41 weeks) and late preterm (34-36 weeks).
• No significant association between ACS exposure and infection risk was observed in very preterm infants (born <34 weeks' gestation).
• Incidence rates of infections were higher in ACS-exposed children compared to unexposed children.

Conclusions:

• Antenatal corticosteroid (ACS) exposure is linked to a higher risk of infections in full-term children up to age 21.
• No increased infection risk was found in preterm infants exposed to ACS before 34 weeks' gestation.
• Stricter criteria for ACS administration and improved preterm birth prediction are necessary to minimize potential adverse effects.