What is the impact of antenatal corticosteroid treatment on risk for mental and behavioral disorders in offspring?

The use of antenatal corticosteroid treatment is considered standard care to accelerate a fetus’ maturation when birth before 34 weeks of gestation is considered imminent. The long-term outcomes of this exposure on the offspring is limited. A recent report in JAMA examines whether exposure was tied to mental and behavioral disorders in the offspring.¹

Researchers used the Finnish nationwide registry of births to find all singleton live births who had survived until age 1 year. The children were born between January 1, 2006, and December 31, 2017, and they were followed up until December 31, 2017. There were 670,097 births that were eligible to be included in the analysis. The median length of follow-up was 5.8 years.

There were 14,868 children who had been exposed to corticosteroid treatment of which 6730 were born at term and 8138 children who were born preterm. Among the 655,229 who had no exposure, 634,757 were born and term and 20,472 were born preterm. When compared with nonexposure, corticosteroid treatment was significantly linked to a higher risk of any mental and behavioral disorder in the entire cohort of children. Among only the preterm-born children, the cumulative incidence rate of any mental and behavioral disorder was still significantly higher among children who were exposed to the treatment when compared with children who had no exposure.

The researchers concluded that exposure to antenatal corticosteroid treatment was significantly linked to mental and behavioral disorders in the offspring. They said their conclusion should be considered when determining whether to use maternal antenatal corticosteroid treatment.

References:

1.    Räikkönen K, Gissler M, Kajantie E. Associations between maternal antenatal corticosteroid treatment and mental and behavioral disorders in children. JAMA. 2020;323(19):1924-1933. doi: 10.1001/jama.2020.3937