Antenatal corticosteroids for preterm birth: dose‐dependent reduction in birthweight, length and head circumference

Norberg, Hanna; Stålnacke, Jannica; Heijtz, Rochellys Diaz; Smedler, Ann-Charlotte; Nyman, Margareta; Forssberg, Hans; Norman, Mikael

doi:10.1111/j.1651-2227.2010.02074.x

Cited by 37 publications

(21 citation statements)

References 24 publications

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“…Prenatally repeated dosages of corticosteroids seem to have an association with a smaller birth size in weight, height, and head circumference. (25,26) There is one study that shows that there is no difference in weight, height, and head circumference at the age of two years between the preterm infants who received multiple courses of antenatal steroids and a placebo group. (27) We did not find any difference in infant growth rates in length or growth markers between the infants who either had or had not been exposed to maternal corticosteroid therapy prenatally, but repeated doses were not used.…”

Section: Discussionmentioning

confidence: 99%

Urinary osteocalcin and serum pro-C-type natriuretic peptide predict linear catch-up growth in infants

Kilpeläinen

Ivaska

Kuiri-Hänninen

et al. 2012

Journal of Bone and Mineral Research

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Preterm (PT) infants are at risk of growth failure despite advanced early care and nutrition. In addition to poor weight gain, slow postnatal linear growth also is associated with adverse neurological outcome. Markers distinguishing infants at risk for impaired catch-up growth are needed. The aim of this longitudinal study was to determine the extent to which postnatal levels of circulating cartilage (serum pro-C-type natriuretic peptide [S-proCNP]) and urinary bone metabolic markers (urinary osteocalcin [MidOC] and two forms of C-terminal cross-linked telopeptide of type I collagen [U-a-CTX-I and U-b-CTX-I]) predict catch-up growth in infancy in 67 PT and 58 full-term (FT) infants. PT infants were significantly shorter than FT infants during the first 6 months of life, but no statistically significant difference was found at the corrected age of 14 months (M14). At the age of 3 months (M3), S-ProCNP and U-MidOC levels, but not U-a-CTX-I and U-b-CTX-I levels, correlated positively with prospective growth velocity from M3 to M14 (r ¼ 0.460, p < 0.001 and r ¼ 0.710, p < 0.001, respectively). In predicting slow linear growth (growth velocity at the lowest quartile), the area under the S-ProCNP ROC curve was 0.662 and that of U-MidOC 0.891. Thus, U-MidOC, and to lesser extent S-ProCNP at M3 are predictors of catch-up growth in infancy. ß

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Section: Discussionmentioning

confidence: 99%

Urinary osteocalcin and serum pro-C-type natriuretic peptide predict linear catch-up growth in infants

Kilpeläinen

Ivaska

Kuiri-Hänninen

et al. 2012

Journal of Bone and Mineral Research

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“…Since the trials conducted by Liggins and Howie in 19726), many observational and controlled studies have reported that antenatal administration of glucocorticoids (GCs) to mothers at risk of preterm birth decreases the severity of respiratory distress syndrome and improves the survival of preterm infants6,7,8,9,10). However, repeated courses of antenatal GCs may be associated with reduced fetal brain growth and long-term neurodevelopmental impairment10,11,12,13,14,15,16,17). Several studies of systematic reviews and meta-analyses have shown that postnatal use of GCs to prevent or treat chronic lung disease (CLD) in preterm infants may facilitate extubation and decrease the incidence of bronchopulmonary dysplasia (BPD), but have found that it increases the risk of neurodevelopmental impairment and cerebral palsy (CP), particularly in infants treated with dexamethasone within the first week of life2,3,4,5,18,19,20,21,22,23,24).…”

Section: Introductionmentioning

confidence: 99%

Evidence for adverse effect of perinatal glucocorticoid use on the developing brain

Chang

2014

Korean J Pediatr

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The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.

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“…The concept of the programming has its roots since 50 years ago (163) and proven by both animal (152,164) and human studies (119,149), however, the mechanism that events during intrauterine life are carried in the memory of every molecule, gene, cell, tissue and systems` organs of the body still not completely revealed. Many hypotheses have been proposed with their inherited power and weakness.…”

Section: Proposed Mechanism Of Fetal Programming Of Adult Diseasementioning

confidence: 99%

“…In fact, multiple courses of antenatal GCs have been found to be associated with reduction in ponderal measurements including birth weight, height (116)(117)(118)(119)(120) and birth head circumference (117,119,121) and higher infant blood pressure and myocardial wall thickness (122,123) also with maternal infection such as chorioamnionitis and endometritis (116,121,124). Rodríguez-Pinilla also reported that antenatal exposure to single steroid course is able to produce similar effects of multiple courses on birth weight and height but not head circumference (117).…”

Section: Antenatal Synthetic Steroid (Dexamethasone and Betamethsone)mentioning

confidence: 99%

Glucocorticoids: Biochemical Group That Play Key Role in Fetal Programming of Adult Disease

Erhuma¹

2012

Glucocorticoids - New Recognition of Our Familiar Friend

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Antenatal corticosteroids for preterm birth: dose‐dependent reduction in birthweight, length and head circumference

Abstract: Multiple courses of ACS are associated with a dose-dependent decline in foetal growth, which may affect later development and health.

Cited by 37 publications

References 24 publications

Urinary osteocalcin and serum pro-C-type natriuretic peptide predict linear catch-up growth in infants

Urinary osteocalcin and serum pro-C-type natriuretic peptide predict linear catch-up growth in infants

Evidence for adverse effect of perinatal glucocorticoid use on the developing brain

Glucocorticoids: Biochemical Group That Play Key Role in Fetal Programming of Adult Disease

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