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, the Co-OPT Collaboration
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Stock, the Co-OPT Collaboration","doi":"10.1111/1471-0528.18101","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To examine the associations of antenatal corticosteroid (ACS) exposure with neurodevelopment in early childhood, and how these vary with gestational age at birth.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Population-based cohort study.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>Scotland, UK.</p>\n </section>\n \n <section>\n \n <h3> Population</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Main Outcome Measures</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":50729,"journal":{"name":"Bjog-An International Journal of Obstetrics and Gynaecology","volume":"132 7","pages":"902-915"},"PeriodicalIF":4.7000,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1471-0528.18101","citationCount":"0","resultStr":"{\"title\":\"Associations of Antenatal Corticosteroids With Neurodevelopment in Children Aged 27–30 Months: A Population-Based Cohort Study\",\"authors\":\"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. 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引用次数: 0
摘要
目的：研究产前皮质类固醇（ACS）暴露与儿童早期神经发育的关系，以及这些关系如何随出生胎龄变化。设计：基于人群的队列研究。背景：英国苏格兰。人口：2011年1月1日至2017年12月31日期间，28-41周出生的单胎儿童285 637名，在27-30个月大时接受了健康检查。方法：采用Logistic和线性回归分析，按出生时妊娠（28- 33,34 - 36,37 -38和39-41周）分层，评估ACS暴露与神经发育结局之间的关系，并对产妇年龄、体重指数、糖尿病、产前吸烟、胎次、邻里剥夺、出生年份、儿童性别和年龄进行调整。主要结果测量：医生确定对任何神经发育领域的关注，以及父母评定的年龄和阶段问卷（ASQ-3）中神经发育里程碑的五个领域得分的平均值。结果：调整协变量后，ACS暴露与妊娠28-33周出生的儿童神经发育问题减少（OR = 0.79, 95% CI = 0.62-0.999）相关，与妊娠34-36周出生的儿童神经发育问题增加相关（OR = 1.11, 95% CI = 1.01-1.21）。在妊娠后期出生的儿童中没有出现独立的关联。ACS暴露与任何胎龄组的ASQ-3评分无关。结论：在儿童早期，ACS暴露与妊娠28-33周出生的儿童的神经发育问题有统计学显著降低相关，与妊娠34-36周出生的儿童的神经发育问题有统计学显著增加相关。然而，这些关联的效应量很小。未发现ACS暴露与足月出生儿童神经发育之间的独立关联。
Associations of Antenatal Corticosteroids With Neurodevelopment in Children Aged 27–30 Months: A Population-Based Cohort Study
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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