Association between infertility and incident onset of systemic autoimmune rheumatic disease after childbirth: a population-based cohort study
Scime NV, Velez MP, Choi MY, Ray JG, Boblitz A, Brown HK. Hum Reprod. 2024; deae253.
Objectives — Antenatal corticosteroids (ACS) decrease neonatal mortality and morbidity among preterm neonates, yet there has been concern regarding their long-term safety. We hypothesised that potential long-term adverse effects of ACS may be observed among infants born during the late preterm period (LPT, 340/7-366/7 weeks of gestation), when the benefits of ACS are subtle.
Design — Population-based, retrospective cohort.
Setting — Ontario, Canada, between 2006 and 2011.
Patients — All live singleton infants born during the LPT period with a minimum 5-year follow-up.
Interventions — Exposure to ACS prior to 340/7 weeks of gestation.
Main Outcome Measures — Suspected neurocognitive disorder, audiometry testing or visual testing.
Results — Overall, 25 668 infants were eligible for analysis, of whom 2689 (10.5%) received ACS. Infants in the ACS group had lower mean birth weight and higher rates of birth weight <10th percentile, neonatal resuscitation and neonatal intensive care unit admission. At 5 years of age, ACS exposure was associated with an increased risk of suspected neurocognitive disorder (adjusted HR (aHR) 1.12, 95% CI 1.05 to 1.20), audiometry testing (aHR 1.20, 95% CI 1.10 to 1.31) and visual testing (aHR 1.06, 95% CI 1.01 to 1.11).
Conclusion — In children born during the LPT period, exposure to ACS prior to 340/7 weeks of gestation is associated with an increased utilisation of the healthcare system related to audiometry and visual testing and suspected neurocognitive disorders by 5 years of age.
Aviram A, Murphy K, McDonald S, Asztalos E, Zaltz A, Redelmeier D, Shah B, Barrett J, Melamed N. Arch Dis Child Fetal Neonatal Ed. 2022; 107(3):250-55. Epub 2021 Sep 29.
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