Gestational Exposure to Maternal Systemic Glucocorticoids and Childhood Risk of CKD,American Journal of Kidney Diseases

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Gestational Exposure to Maternal Systemic Glucocorticoids and Childhood Risk of CKD
American Journal of Kidney Diseases ( IF 13.2 ) Pub Date : 2024-03-11 , DOI: 10.1053/j.ajkd.2024.01.523
You-Lin Tain , Lung-Chih Li , Hsiao-Ching Kuo , Chien-Ning Hsu

The potential effects of antenatal glucocorticoid exposure on the health of children are unclear. We examined the association of gestational exposure to maternal systemic glucocorticoids (SG) and the risk of developing chronic kidney disease (CKD) in childhood. Retrospective cohort study. Newborns cared for at the largest healthcare delivery system in Taiwan between 2004 and 2018. Maternal prescriptions for SG between the last menstrual period and birth as a proxy for gestational exposure. Incidence of childhood CKD, including congenital anomalies of the kidney and urinary tract (CAKUT) and other kidney diseases (non-CAKUT) over 10 years. Cox proportional hazards models with stabilized inverse probability of treatment weighting and robust sandwich estimator were used to estimate the average association between SG and incident CKD after adjustment for offspring characteristics (aHR). Among 23,363 singleton-born children, gestational SG exposure was significantly associated with a higher risk of childhood CKD (aHR, 1.69 [95% CI, 1.01–2.84]). Stratified analyses showed stronger associations between SG and childhood CKD within the strata of birth <37 weeks gestational age (aHR, 2.38 [95% CI, 1.19–4.78]), male sex (aHR, 1.89 [95% CI, 1.00–3.55]), gestational exposure in the second trimester (aHR, 6.70 [95% CI, 2.17–20.64]), and total dose >24 mg hydrocortisone equivalent (aHR, 1.91 [95% CI, 1.05–3.47). Study was limited to the Taiwan healthcare delivery system and childhood CKD events through age 10 years. The findings of this study suggest that gestational exposure to systemic glucocorticoids is associated with the occurrence of kidney disease in childhood. If these findings are confirmed, they may inform clinicians who are considering prescribing SG during pregnancy.

更新日期：2024-03-11

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