The DOI matches its Crossref record; 30 of the 31 references it cites were found in a registry or an index.
Associations Between Maternal Antenatal Corticosteroid Treatment and Mental and Behavioral Disorders in Children
Open accessAbstract
Importance: Maternal antenatal corticosteroid treatment is standard care to accelerate fetal maturation when birth before 34 weeks is imminent. Recently, expansion of the indications beyond 34 gestational weeks has been debated. However, data about long-term outcomes remain limited, especially among infants who after treatment exposure are born at term. Objective: To study if antenatal corticosteroid treatment is associated with mental and behavioral disorders in children born at term (≥37 weeks 0 days' gestation) and preterm (<37 weeks 0 days' gestation) and if unmeasured familial confounding explains these associations. Design, Setting, and Participants: Population-based retrospective cohort study using nationwide registries of all singleton live births in Finland surviving until 1 year and a within-sibpair comparison among term siblings. Children were born between January 1, 2006, and December 31, 2017, and followed up until December 31, 2017. Exposures: Maternal antenatal corticosteroid treatment. Main Outcomes and Measures: Primary outcome was any childhood mental and behavioral disorder diagnosed in public specialized medical care settings. Results: Of the 674 877 singleton children born in Finland during the study period, 670 097 were eligible for analysis. The median length of follow-up was 5.8 (interquartile-range, 3.1-8.7) years. Of the 14 868 (2.22%; 46.1% female) corticosteroid treatment-exposed children, 6730 (45.27%) were born at term and 8138 (54.74%) were born preterm; of the 655 229 (97.78%; 48.9% female) nonexposed children, 634 757 (96.88%) were born at term and 20 472 (3.12%) were born preterm. Among the 241 621 eligible term-born maternal sibpairs nested within this population, 4128 (1.71%) pairs were discordant for treatment exposure. Treatment exposure, compared with nonexposure, was significantly associated with higher risk of any mental and behavioral disorder in the entire cohort of children (12.01% vs 6.45%; absolute difference, 5.56% [95% CI, 5.04%-6.19%]; adjusted hazard ratio [HR], 1.33 [95% CI, 1.26-1.41]), in term-born children (8.89% vs 6.31%; absolute difference, 2.58% [95% CI, 1.92%-3.29%]; HR, 1.47 [95% CI, 1.36-1.69]), and when sibpairs discordant for treatment exposure were compared with sibpairs concordant for nonexposure (6.56% vs 4.17% for within-sibpair differences; absolute difference, 2.40% [95% CI, 1.67%-3.21%]; HR, 1.38 [95% CI, 1.21-1.58]). In preterm-born children, the cumulative incidence rate of any mental and behavioral disorder was also significantly higher for the treatment-exposed compared with the nonexposed children, but the HR was not significant (14.59% vs 10.71%; absolute difference, 3.38% [95% CI, 2.95%-4.87%]; HR, 1.00 [95% CI, 0.92-1.09]). Conclusions and Relevance: In this population-based cohort study, exposure to maternal antenatal corticosteroid treatment was significantly associated with mental and behavioral disorders in children. These findings may help inform decisions about maternal antenatal corticosteroid treatment.
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“Recent literature has suggested the need for a more judicious approach to administration of antenatal corticosteroids due to growing concerns about potential long-term neurodevelopmental effects of in-utero corticosteroid exposure.”
From Artificial intelligence in obstetric ultrasound: A scoping review. (2023) · cites this paper as [141]
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“Moreover, first trimester Dex exposure of non-CAH fetuses is associated with differences in brain morphology (489).”
From Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management (2022) · cites this paper as [489]
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Prevalence and development of psychiatric disorders in childhood and adolescence
Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.8.837 · Cited by 4,035
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Sweet, D. G., Carnielli, V. P., Greisen, G. O., Hallman, M., Özek, E., Pas, A. B. T., Plavka, R., Roehr, C. C., Saugstad, O. D., Siméoni, U., et al. (2019) · Neonatology · doi:10.1159/000499361 · Cited by 1,611
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Antenatal Betamethasone for Women at Risk for Late Preterm Delivery
Gyamfi-Bannerman, C., Thom, E. A., Blackwell, S. C., Tita, A. T. N., Reddy, U. M., Saade, G. R., Rouse, D. J., McKenna, D. S., Clark, E. A. S., Thorp, J. M., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1516783 · Cited by 814
Antenatal Corticosteroids for Women at Risk of Late Preterm Delivery
Gyamfi-Bannerman, C., Thom, E., Blackwell, S. C., Tita, A., Reddy, U., Saade, G., Rouse, D., McKenna, D., Clark, E. A. S., Thorp, J. M., et al. (2016) · New England Journal of Medicine · doi:10.1097/01.ogx.0000489576.69844.54 · Cited by 619
Committee Opinion No. 713: Antenatal Corticosteroid Therapy for Fetal Maturation
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Adult Functional Outcomes of Common Childhood Psychiatric Problems
Copeland, W., Dieter Wolke, C., Shanahan, L., & Costello, E. J. (2015) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2015.0730 · Cited by 516
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European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update
Sweet, D. G., Carnielli, V. P., Greisen, G. O., Hallman, M., Klebermaß-Schrehof, K., Özek, E., Pas, A. B. T., Plavka, R., Roehr, C. C., Saugstad, O. D., et al. (2023) · Neonatology · doi:10.1159/000528914 · Cited by 714
Congenital Adrenal Hyperplasia—Current Insights in Pathophysiology, Diagnostics, and Management
Claahsen - van der Grinten, H. L., Speiser, P. W., Ahmed, S. F., Arlt, W., Auchus, R. J., Falhammar, H., Flück, C. E., Guasti, L., Huebner, A., Kortmann, B. B. M., et al. (2022) · Endocrine Reviews · doi:10.1210/endrev/bnab016 · Cited by 556
Antenatal corticosteroids to reduce neonatal morbidity and mortality
Stock, S., Thomson, A., & Papworth, S. (2022) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/1471-0528.17027 · Cited by 232
Evaluation of Long-term Outcomes Associated With Preterm Exposure to Antenatal Corticosteroids
Ninan, K., Liyanage, S. K., Murphy, K. E., Asztalos, E. V., & McDonald, S. D. (2022) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/jamapediatrics.2022.0483 · Cited by 190
Family planning considerations in people with multiple sclerosis
Krysko, K. M., Dobson, R., Alroughani, R., Amato, M. P., Bove, R. M., Ciplea, A. I., Fragoso, Y. D., Houtchens, M. K., Jokubaitis, V., Magyari, M., et al. (2023) · The Lancet Neurology · doi:10.1016/s1474-4422(22)00426-4 · Cited by 140
Metadata
- Authors
- Räikkönen, K., Gissler, M., & Kajantie, E.
- Affiliations
- University of Helsinki (FI)
- University of Turku (FI)
- Corresponding author
- Räikkönen, Katri
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2020-05-19
- Volume
- 323
- Issue
- 19
- Pages
- 1924
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC7237984
- OpenAlex
- W3027678838
- Cited by
- 327
- References
- 31
- Citations by year
- 2026: 33 · 2025: 58 · 2024: 44 · 2023: 59 · 2022: 68 · 2021: 45 · 2020: 20
- FWCI
- 47.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- European Commission
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek (462-16-040)
- Lastentautien Tutkimussäätiö
- Novo Nordisk Fonden (NNF19OC0057393)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- antenatal corticosteroids, child psychopathology, behavioral disorders, term birth, preterm birth, long-term outcomes, familial confounding, fetal maturity, singleton live births, birth cohort
- MeSH terms
- Adrenal Cortex Hormones, Mental Disorders, Child, Child Behavior Disorders, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Newborn, Infant, Premature, Male, Pregnancy, Prenatal Care, Prenatal Exposure Delayed Effects, Retrospective Studies
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