Background

Antenatal corticosteroids improve neonatal outcomes when administered to infants who are at risk of preterm delivery. Many women who receive antenatal corticosteroids for threatened preterm labor proceed to deliver at term. Thus, long-term outcomes should be evaluated for term-born infants who were exposed to antenatal corticosteroids in utero.

Objective

This study aimed to compare long-term outcomes between term-born children aged ≥5 years who were born to women who received antenatal corticosteroids for threatened preterm labor and children whose mothers were also evaluated for threatened preterm labor but did not receive antenatal corticosteroids.

Study Design

We performed a retrospective cohort study of children born at ≥37 weeks’ gestation, aged ≥5 years, and born to mothers diagnosed with threatened preterm labor during pregnancy. The primary exposure of interest was receiving antenatal corticosteroids. Among the collected childhood medical conditions, the primary outcome of interest was a diagnosis of asthma.

Results

Of the 3556 term-born children aged ≥5 years, 629 (17.6%) were exposed to antenatal corticosteroids (all betamethasone), and 2927 (82.3%) were controls whose mothers were evaluated for threatened preterm birth but did not get antenatal corticosteroid injections. Women receiving antenatal corticosteroids had higher rates of maternal comorbidities (diabetes mellitus, hypertension; P≤.01). Antenatal corticosteroid-exposed children had no difference in diagnosis of asthma (12.6% vs 11.6%), attention deficit disorder, or developmental delay (P=.47, .54, and .10, respectively). Controlling for maternal and neonatal characteristics, asthma was not different between those exposed to antenatal corticosteroids and controls (odds ratio, 1.05; 95% confidence interval, 0.79–1.39). The odds of the child’s weight percentile being <10% were increased for antenatal corticosteroid-exposed children born at term (odds ratio, 2.00; 95% confidence interval, 1.22–3.25).

Conclusion

Children born at term who were exposed to antenatal corticosteroids may have increased odds of being in a lower growth percentile than those not exposed. However, rates of diagnoses such as asthma, developmental delay, and attention deficit disorders were not different.

中文翻译：

---

接触产前皮质类固醇的足月出生婴儿的长期儿童结局

 背景

对有早产风险的婴儿使用产前皮质类固醇可以改善新生儿结局。许多因早产先兆而接受产前皮质类固醇治疗的妇女会继续足月分娩。因此，应对在子宫内接触产前皮质类固醇的足月婴儿的长期结局进行评估。

 客观的

本研究旨在比较因先兆早产而接受产前皮质类固醇治疗的妇女所生的年龄≥5岁的足月出生儿童和母亲也接受先兆早产评估但未接受产前皮质类固醇治疗的儿童之间的长期结局。

 研究设计

我们对妊娠≥37周出生、年龄≥5岁以及妊娠期间被诊断为先兆早产的母亲所生的儿童进行了一项回顾性队列研究。感兴趣的主要暴露是接受产前皮质类固醇。在收集的儿童健康状况中，我们感兴趣的主要结果是哮喘的诊断。

 结果

在 3556 名年龄≥5 岁的足月出生儿童中，629 名（17.6%）接受了产前皮质类固醇（均为倍他米松），2927 名（82.3%）为对照，其母亲接受了先兆早产评估，但未接受产前皮质类固醇注射。接受产前皮质类固醇治疗的女性产妇合并症（糖尿病、高血压； P ≤.01）的发生率较高。产前接触皮质类固醇的儿童在哮喘（12.6% vs 11.6%）、注意力缺陷障碍或发育迟缓的诊断方面没有差异（ P分别为 0.47、0.54 和 0.10）。控制孕产妇和新生儿的特征后，暴露于产前皮质类固醇的患者和对照组之间的哮喘没有差异（比值比，1.05；95%置信区间，0.79-1.39）。对于产前接触皮质类固醇的足月出生儿童，其体重百分位数为 <10% 的几率增加（优势比，2.00；95% 置信区间，1.22–3.25）。

 结论

接触过产前皮质类固醇的足月出生的儿童可能比未接触过皮质类固醇的儿童处于较低生长百分位的几率更高。然而，哮喘、发育迟缓和注意力缺陷障碍等诊断率并无差异。