TY - JOUR
T1 - Antenatal glucocorticoid treatment is not associated with long-term metabolic risks in individuals born before 32 weeks of gestation
AU - Finken, M. J. J.
AU - Keijzer-Veen, M. G.
AU - Dekker, F. W.
AU - Frölich, M.
AU - Walther, F. J.
AU - Romijn, J. A.
AU - van der Heijden, B. J.
AU - Wit, J. M.
AU - AUTHOR GROUP
AU - Hille, E. T. M.
AU - de Groot, C. H.
AU - Kloosterboer-Boerrigter, H.
AU - den Ouden, A. L.
AU - Rijpstra, A.
AU - Verloove-Vanhorick, S. P.
AU - Vogelaar, J. A.
AU - Kok, J. H.
AU - Ilsen, A.
AU - van der Lans, M. van der Lans
AU - Boelen-van der Loo, W. J. C.
AU - Lundqvist, T.
AU - Heymans, H. S. A.
AU - Duiverman, E. J.
AU - Geven, W. B.
AU - Duiverman, M. L.
AU - Geven, L. I.
AU - Vrijlandt, E. J. L. E.
AU - Mulder, A. L. M.
AU - Gerver, A.
AU - Kollée, L. A. A.
AU - Reijmers, L.
AU - Sonnemans, R.
AU - Weisglas-Kuperus, N.
AU - van der Heijden, A. J.
AU - van Goudoever, J. B.
AU - van Weissenbruch, M. M.
AU - Cranendonk, A.
AU - Delemarre-van de Waal, H. A.
AU - de Groot, L.
AU - Samsom, J. F.
AU - de Vries, L. S.
AU - Rademaker, K. J.
AU - Moerman, E.
AU - Voogsgeerd, M.
AU - de Kleine, M. J. K.
AU - Andriessen, P.
AU - Dielissen-van Helvoirt, C. C. M.
AU - Mohamed, I.
AU - van Straaten, H. L. M.
AU - Baerts, W.
AU - Veneklaas Slots-Kloosterboer, G. W.
AU - Frolich, M.
PY - 2008
Y1 - 2008
N2 - BACKGROUND: A single course of maternal glucocorticoid treatment is effective in reducing neonatal mortality after preterm birth. However, in animals, maternal glucocorticoid treatment is associated with lifelong hyperglycaemia and hypertension, and impaired nephrogenesis in offspring. Findings from studies in humans on this topic are highly contradictory due to a number of methodological flaws, and renal function after glucocorticoid exposure has never been assessed. OBJECTIVES: To assess in individuals born <32 gestational weeks whether antenatal glucocorticoid treatment for preterm birth is associated with long-term metabolical risks, including renal function, in adulthood. DESIGN: Birth cohort study. SETTING: Multicentre study. PATIENTS: 412 19 year olds born <32 gestational weeks from the Project On Preterm and Small-for-gestational-age infants (POPS) cohort. INTERVENTIONS: Maternal betamethasone 12 mg administered twice with a 24 h interval. MAIN OUTCOME MEASURES: Body composition, insulin resistance, the serum lipid profile, blood pressure and estimated renal function. RESULTS: We did not find any long-term adverse effects of antenatal betamethasone, with the exception of an effect on glomerular filtration rate (GFR). In 19-year-old survivors, GFR was lower after betamethasone: -5.2 ml/min (95% CI -8.9 to -1.4) per 1.73 m(2). CONCLUSIONS: The reduction in neonatal mortality associated with a single course of maternal betamethasone is not accompanied by long-term metabolical risks in survivors of preterm birth. The only adverse effect found was lower GFR. Although this difference was not clinically relevant at 19 years, it might predict an increased risk of chronic renal failure in prematurely born individuals who were exposed antenatally to betamethasone
AB - BACKGROUND: A single course of maternal glucocorticoid treatment is effective in reducing neonatal mortality after preterm birth. However, in animals, maternal glucocorticoid treatment is associated with lifelong hyperglycaemia and hypertension, and impaired nephrogenesis in offspring. Findings from studies in humans on this topic are highly contradictory due to a number of methodological flaws, and renal function after glucocorticoid exposure has never been assessed. OBJECTIVES: To assess in individuals born <32 gestational weeks whether antenatal glucocorticoid treatment for preterm birth is associated with long-term metabolical risks, including renal function, in adulthood. DESIGN: Birth cohort study. SETTING: Multicentre study. PATIENTS: 412 19 year olds born <32 gestational weeks from the Project On Preterm and Small-for-gestational-age infants (POPS) cohort. INTERVENTIONS: Maternal betamethasone 12 mg administered twice with a 24 h interval. MAIN OUTCOME MEASURES: Body composition, insulin resistance, the serum lipid profile, blood pressure and estimated renal function. RESULTS: We did not find any long-term adverse effects of antenatal betamethasone, with the exception of an effect on glomerular filtration rate (GFR). In 19-year-old survivors, GFR was lower after betamethasone: -5.2 ml/min (95% CI -8.9 to -1.4) per 1.73 m(2). CONCLUSIONS: The reduction in neonatal mortality associated with a single course of maternal betamethasone is not accompanied by long-term metabolical risks in survivors of preterm birth. The only adverse effect found was lower GFR. Although this difference was not clinically relevant at 19 years, it might predict an increased risk of chronic renal failure in prematurely born individuals who were exposed antenatally to betamethasone
U2 - https://doi.org/10.1136/adc.2007.128470
DO - https://doi.org/10.1136/adc.2007.128470
M3 - Article
C2 - 18450806
SN - 1359-2998
VL - 93
SP - F442-F447
JO - Archives of disease in childhood. Fetal and neonatal edition
JF - Archives of disease in childhood. Fetal and neonatal edition
IS - 6
ER -