Associations of Antenatal Corticosteroids With Neurodevelopment in Children Aged 27–30 Months: A Population-Based Cohort Study

Emily M. Frier*, Marius Lahti-Pulkkinen, Chun Lin, Fabienne Decrue, Helga Zoega, Karel Allegaert, Jasper Been, David Burgner, Kate Duhig, Kristjana Einarsdóttir, Lani Florian, Abigail Fraser, Mika Gissler, Cynthia Gyamfi-Bannerman, Lars Henning Pedersen, Jessica Miller, Ben W. Mol, Sarah Murray, Jane Norman, Devender RobertsEwoud Schuit, Ting Shi, Aziz Sheikh, Joshua P. Vogel, Rachael Wood, Emma McGoldrick, Bo Jacobsson, Eyal Krispin, Rebecca M. Reynolds, Sarah J. Stock,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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.

Original languageEnglish
Article numberdoi.org/10.1111/1471-0528.18101
Pages (from-to)902-915
Number of pages14
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume132
Issue number7
Early online date19 Feb 2025
DOIs
Publication statusPublished - Jun 2025

Keywords

  • antenatal corticosteroids
  • neurodevelopment
  • preterm birth

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