Neurodevelopment in Term Infants with Normal Birthweight following Postnatal Systemic Steroid Exposure.

IF 3.2 3区 医学 Q2 CLINICAL NEUROLOGY
Neuroepidemiology Pub Date : 2024-01-01 Epub Date: 2024-01-31 DOI:10.1159/000536100
Yoon Young Yi, Eun Kyo Ha, Jiwoon Shin, Hey-Sung Baek, Hye Ryeong Cha, Ju Hee Kim, Man Yong Han
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Abstract

Introduction: Studies investigating the potential impact of systemic steroid exposure during early infancy on neurological development in full-term infants with normal birth weight are lacking.

Methods: This population-based administrative cohort study used data of national health insurance and a health-screening program for infants and children and included full-term infants who were born in Korea between 2008 and 2012 with normal birth weight and did not have any specific perinatal or neurodevelopmental diseases. The prescription of systemic steroids within the first 3 months of age was mainly considered. The neurological development of children was assessed using the Korean Development Screening Test (K-DST) at 6 years of age. To balance the baseline characteristics of the control and exposed groups, stabilized inverse probability of treatment weighting with trimming was performed in the main cohort. Ordinal logistic regression was used to assess the association between systemic steroid exposure and unfavorable results in the K-DST.

Results: The control and exposure groups had 246,168 and 5,083 children, respectively. The K-DST suggested unfavorable results in 8.1% and 8.6% children in the control and exposure groups, respectively (weighted odds ratio, 95% confidence interval, 1.03, 0.93-1.14). When each domain of the K-DST was considered separately, the risk of unfavorable results in the exposed group was not significantly different from that in the control group.

Conclusions: No significant association was observed between exposure to systemic steroids during early infancy and neurodevelopmental impairment at 6 years of age.

出生时体重正常的足月婴儿在产后系统性接触类固醇后的神经发育。
背景:目前尚无研究调查婴儿早期全身类固醇暴露对出生体重正常的足月婴儿神经系统发育的潜在影响:这项基于人群的行政队列研究使用了国民健康保险和婴幼儿健康筛查项目的数据,研究对象包括 2008 年至 2012 年间在韩国出生、出生体重正常、无任何特殊围产期疾病或神经发育疾病的足月婴儿。主要考虑了出生后 3 个月内使用全身性类固醇的情况。研究人员使用韩国发育筛查测试(Korean Development Screening Test,K-DST)对6岁儿童的神经系统发育情况进行了评估。为了平衡对照组和暴露组的基线特征,在主要队列中采用了稳定的反向治疗概率加权法(Inverse Probability of Treatment Weighting with trimming)。采用正序逻辑回归评估全身类固醇暴露与 K-DST 不利结果之间的关联:对照组和暴露组分别有 246 168 名和 5 083 名儿童。对照组和暴露组分别有 8.1% 和 8.6% 的儿童在 K-DST 中出现不良结果(加权几率比 [OR],95% 置信区间 [CI],1.03, 0.93 - 1.14)。如果分别考虑K-DST的每个领域,暴露组出现不良结果的风险与对照组没有显著差异:结论:婴儿早期接触全身性类固醇与6岁时的神经发育障碍之间没有明显关联。
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来源期刊
Neuroepidemiology
Neuroepidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
9.90
自引率
1.80%
发文量
49
审稿时长
6-12 weeks
期刊介绍: ''Neuroepidemiology'' is the only internationally recognised peer-reviewed periodical devoted to descriptive, analytical and experimental studies in the epidemiology of neurologic disease. The scope of the journal expands the boundaries of traditional clinical neurology by providing new insights regarding the etiology, determinants, distribution, management and prevention of diseases of the nervous system.
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