Antenatal Dexamethasone Exposure in Preterm Infants Is Associated with Allergic Diseases and the Mental Development Index in Children

Abstract

Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to investigate the association between antenatal dexamethasone and T cell expression in childhood allergic diseases. Methods: We recruited a cohort of preterm infants born at Kaohsiung Chang Gung Memorial Hospital between 2007 and 2010 with a gestational age of less than 35 weeks and body weight at birth of less than 1500 g. The status of antenatal exposure to steroids and allergic diseases were surveyed using a modified ISAAC questionnaire for subjects aged 2–5 years old. We analyzed Th1/Th2/Th17 expression of mRNA, cytokines (using the Magpix® my-system), and mental development index (MDI). Results: Among the 40 patients that were followed, the data showed that the antenatal dexamethasone exposure group (N = 24) had a significantly higher incidence of allergic diseases (75.0% vs. 18.8%, p < 0.0001) when compared to the non-dexamethasone exposure group (N = 16), especially with regard to asthma (41.7% vs. 0.0%, p = 0.003) and allergic rhinitis (58.3% vs. 18.8%, p = 0.013), but not atopic dermatitis. No statistical difference was observed in the mRNA expression levels of total white blood cell count between the dexamethasone exposure and non-exposure groups (p > 0.05). However, the asthma group had higher IL-5 levels (p = 0.009), and the MDI was shown to be significantly higher in the dexamethasone exposure group (90.38 ± 3.31 vs. 79.94 ± 3.58, p = 0.043) while no significant difference was found between the PDI of the two groups. Conclusions: Exposure to antenatal dexamethasone in preterm infants will increase their susceptibility to allergic diseases, particularly asthma and allergic rhinitis. Preterm infants’ exposure to antenatal dexamethasone also results in higher MDI scores. Such increases in allergic diseases may be related to increased IL-5 and IL-10 levels.

Pharmacokinetics and Pharmacodynamics of Intramuscular and Oral Betamethasone and Dexamethasone in Reproductive Age Women in India

“…route, and lymphocyte suppression was also comparable for the BetaP plus BetaA. A concern for clinical use is that corticosteroids have large effects on the developing immune system of the fetus that could alter immune function in the child and adult …”

“…A concern for clinical use is that corticosteroids have large effects on the developing immune system of the fetus that could alter immune function in the child and adult. [33][34][35] The study has limitations as we studied only fasted healthy Indian-Asian women. Extrapolation to other populations of different racial backgrounds, a wide range of BMI, nonfasted, and pregnant women must be done with caution.…”

Factores de riesgo socioambientales asociados a la presencia de síntomas de atopias en niños menores de 3 años

“…Después, se realizó la encuesta de manera presencial previo consentimiento informado. [16][17][18] Se compiló los datos en una tabla, se dividieron los participantes en dos grupos: casos con atopias y casos sin atopias.…”

Influences of Maternal Factors Over Offspring Allergies and the Application for Food Allergy

“…Maternal severe asthma without using inhalant corticosteroid treatment related to reduced birth weights of female children (149). However, prenatal exposure of preterm infants to dexamethasone, a type of corticosteroid medication, increased their susceptibility to allergic diseases, especially asthma and allergic rhinitis (82). In a Danish cohort study that employed 675,379 singletons, children from mothers with mild uncontrolled asthma, moderate-to-severe controlled asthma, and moderate-to-severe uncontrolled asthma showed higher prevalence of early-onset persistent asthma than those of mothers with mild controlled asthma (93), indicating that the severity and control of maternal asthma increase risk for offspring asthma.…”