Antenatal corticosteroids and neurodevelopmental outcomes in late preterm births. Issue 3 (29th September 2021) - Aviram, Amir
Abstract : Objectives: Antenatal corticosteroids (ACS) decrease neonatal mortality and morbidity among preterm neonates, yet there has been concern regarding their long-term safety. We hypothesised that potential long-term adverse effects of ACS may be observed among infants born during the late preterm period (LPT, 34 0/7 –36 6/7 weeks of gestation), when the benefits of ACS are subtle. Design: Population-based, retrospective cohort. Setting: Ontario, Canada, between 2006 and 2011. Patients: All live singleton infants born during the LPT period with a minimum 5-year follow-up. Interventions: Exposure to ACS prior to 34 0/7 weeks of gestation. Main outcome measures: Suspected neurocognitive disorder, audiometry testing or visual testing. Results: Overall, 25 668 infants were eligible for analysis, of whom 2689 (10.5%) received ACS. Infants in the ACS group had lower mean birth weight and higher rates of birth weight <10th percentile, neonatal resuscitation and neonatal intensive care unit admission. At 5 years of age, ACS exposure was associated with an increased risk of suspected neurocognitive disorder (adjusted HR (aHR) 1.12, 95% CI 1.05 to 1.20), audiometry testing (aHR 1.20, 95% CI 1.10 to 1.31) and visual testing (aHR 1.06, 95% CI 1.01 to 1.11). Conclusion: In children born during the LPT period, exposure to ACS prior to 34 0/7 weeks of gestation is associated with an increased utilisation of the healthcare system related to audiometry and visual testing and suspected neurocognitive disorders by 5 years of age. Abstract : In a large population-based dataset of live births at 34-36 weeks' gestation born 2006-2011, exposure to antenatal corticosteroids earlier in gestation may be associated with an increased risk for neurodevelopmental concerns and healthcare utilization at 5-9 years.