Emily M Frier, Marius Lahti-Pulkkinen, Chun Lin, Fabienne Decrue, Helga Zoega, Karel Allegaert, Jasper V Been, David Burgner, Kate Duhig, Kristjana Einarsdóttir, Lani Florian, Abigail Fraser, Mika Gissler, Cynthia Gyamfi-Bannerman, Lars Henning Pedersen, Jessica E Miller, Ben W Mol, Sarah R Murray, Jane Norman, Devender Roberts, Ewoud Schuit, Ting Shi, Aziz Sheikh, Joshua P Vogel, Rachael Wood, Emma McGoldrick, Bo Jacobsson, Eyal Krispin, Rebecca M Reynolds, Sarah J Stock
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引用次数: 0
Abstract
Objective: To examine the associations of antenatal corticosteroid (ACS) exposure with neurodevelopment in early childhood, and how these vary with gestational age at birth.
Design: Population-based cohort study.
Setting: Scotland, UK.
Population: 285 637 singleton children born at 28-41 weeks' gestation, between 1st January 2011 and 31st December 2017, who underwent health reviews at 27-30 months of age.
Methods: Logistic and linear regression analyses, stratified by gestation at birth (28-33, 34-36, 37-38 and 39-41 weeks' gestation), were used to evaluate the associations between ACS exposure and neurodevelopmental outcomes, and adjusted for maternal age, body mass index, diabetes, antenatal smoking, parity, neighbourhood deprivation, birth year, child sex and age at review.
Main outcome measures: Practitioner-identified concerns about any neurodevelopmental domain, and the average of five domain scores on neurodevelopmental milestones from the parent-rated Ages and Stages Questionnaire (ASQ-3).
Results: After adjustment for covariates, ACS exposure was associated with reduced neurodevelopmental concerns in children born at 28-33 weeks' gestation (OR = 0.79, 95% CI = 0.62-0.999) and with increased neurodevelopmental concerns in children born at 34-36 weeks' gestation (OR = 1.11, 95% CI = 1.01-1.21). No independent associations emerged in children born at later gestations. ACS exposure was not associated with ASQ-3 scores in any gestational age group.
Conclusions: In early childhood, ACS exposure was associated with statistically significantly reduced neurodevelopmental concerns in children born at 28-33 weeks' gestation, and with statistically significantly increased neurodevelopment concerns in children born at 34-36 weeks' gestation. However, the effect sizes of these associations were small. No independent associations were found between ACS exposure and neurodevelopment in term-born children.
期刊介绍：
BJOG is an editorially independent publication owned by the Royal College of Obstetricians and Gynaecologists (RCOG). The Journal publishes original, peer-reviewed work in all areas of obstetrics and gynaecology, including contraception, urogynaecology, fertility, oncology and clinical practice. Its aim is to publish the highest quality medical research in women''s health, worldwide.
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