Exposure single course of antenatal corticosteroids was associated with increased risk of adverse neurocognitive and/or psychological outcomes in children born late-preterm and full-term in a study published in JAMA Paediatrics.¹

Researchers from Canada examined the neurodevelopmental and psychological outcomes at one year in children born preterm (<37 weeks of gestation) and full-term (≥37 weeks of gestation) and who had been exposed to antenatal corticosteroids in a systematic review and meta-analysis. Thirty studies involving more than 1.25 million children aged at least 1 year were included in the final analysis.

Analysis of data shows that the risk of neurodevelopmental impairment was considerably lower in children who were born extremely premature and were exposed to a single course of antenatal corticosteroids with an adjusted odds ratio of 0.69. But in late-preterm children, there was a significantly higher risk of neurocognitive disorders after exposure to antenatal corticosteroids with adjusted hazard ratio (aHR) of 1.12. Similarly, the risk of mental or behavioral disorders and neurocognitive disorders was higher in full-term children following exposure to antenatal corticosteroids with aHR of 1.47 and 1.16, respectively.  

The American College of Obstetrics and Gynecology (ACOG) recommends “a single course of corticosteroids for pregnant women between 24 0/7 weeks and 33 6/7 weeks of gestation who are at risk of preterm delivery within 7 days, including for those with ruptured membranes and multiple gestations”.²Â However, the findings of increased risk of neurocognitive and psychological impairment in children with late-preterm and full-term birth suggest the need to exercise caution in administration of antenatal corticosteroids, especially with regard to timing of administration.

References

1. Ninan K, et al. Evaluation of long-term outcomes associated with preterm exposure to antenatal corticosteroids: a systematic review and meta-analysis. JAMA Pediatr. 2022 Apr 11;e220483. doi: 10.1001/jamapediatrics.2022.0483.
2. ACOG. Antenatal corticosteroid therapy for fetal maturation. Committee Opinion, Number 713, August 2017.