Effects of Corticosteroids on Childhood Neurodevelopment

Children born to individuals who received late preterm corticosteroids showed no adverse neurodevelopmental outcomes at age 6 or older ().

Despite concerns about increased neonatal hypoglycemia, no significant differences were found in cognitive or behavioral measures between the corticosteroid and placebo groups, suggesting that the benefits of antenatal corticosteroids for respiratory health do not lead to long-term neurological harm.

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The study, known as the Antenatal Late Preterm Steroids (ALPS) trial, was pivotal in altering clinical practice by demonstrating the efficacy of antenatal betamethasone in reducing short-term neonatal respiratory morbidity.

Conducted as a prospective follow-up study, the research involved children aged 6 years or older whose birthing parent had previously participated in the multicenter randomized clinical trial.

The study spanned across 13 centers that were part of the Maternal-Fetal Medicine Units (MFMU) Network cycle from 2011 to 2016, with follow-up assessments conducted between 2017 and 2022.

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The primary outcome measure of the follow-up study was the General Conceptual Ability score, assessed using the Differential Ability Scales, 2nd Edition (DAS-II).

Secondary outcome measures included assessments of gross motor function, social responsiveness, and behavioral characteristics. Multivariable analyses were performed, adjusting for known variables associated with the primary outcome.

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Influence of Late Preterm Corticosteroids

Initially, these corticosteroids were found to enhance short-term neonatal respiratory outcomes, albeit with an elevated incidence of hypoglycemia.

However, upon assessing childhood neurodevelopmental outcomes at age 6 or older, there were no significant differences observed in the primary outcome measure, the General Conceptual Abilities score, between the groups that received betamethasone and the placebo.

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Results from the study indicated that out of 2831 children initially involved, 1026 were enrolled in the follow-up, with 949 completing the DAS-II assessment.

Among these children, maternal, neonatal, and childhood characteristics were comparable between the betamethasone and placebo groups, except for a higher incidence of neonatal hypoglycemia in the betamethasone group.

However, this disparity did not translate into significant differences in neurodevelopmental outcomes between the two groups.

These findings provide reassurance regarding the safety of using antenatal corticosteroids to improve short-term respiratory outcomes without compromising long-term neurological well-being.

Reference:

Neurodevelopmental Outcomes After Late Preterm Antenatal Corticosteroids - (https://jamanetwork.com/journals/jama/fullarticle/2818051?)

Source-Eurekalert