Reproductive outcomes after antenatal corticosteroids: Secondary analysis of 50-year follow-up of the Auckland steroid randomized trial.

Autor:	St Clair SL; Liggins Institute, The University of Auckland, Auckland, New Zealand., Walters AGB; Liggins Institute, The University of Auckland, Auckland, New Zealand., Crowther CA; Liggins Institute, The University of Auckland, Auckland, New Zealand., Dalziel SR; Department of Pediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand.; Department of Surgery: Child and Youth Heath, University of Auckland, Auckland, New Zealand.; Children's Emergency Department, Starship Children's Hospital, Auckland, New Zealand., Eagleton C; Liggins Institute, The University of Auckland, Auckland, New Zealand., Gamble GD; Liggins Institute, The University of Auckland, Auckland, New Zealand., McKinlay CJD; Department of Pediatrics: Child and Youth Health, University of Auckland, Auckland, New Zealand., Milne BJ; School of Social Sciences and Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand.; Department of Statistics, Faculty of Science, University of Auckland, Auckland, New Zealand., Harding JE; Liggins Institute, The University of Auckland, Auckland, New Zealand.
Jazyk:	angličtina
Zdroj:	Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2024 Dec; Vol. 103 (12), pp. 2412-2425. Date of Electronic Publication: 2024 Oct 04.
DOI:	10.1111/aogs.14984
Abstrakt:	Introduction: Antenatal corticosteroids are widely used to prevent morbidity and mortality after preterm birth, but there are ongoing concerns about the possible risk of long-term adverse effects, including perturbation of endocrine systems, with potential implications for reproduction. A small number of animal studies have suggested possible adverse effects on reproduction after antenatal exposure to corticosteroids, but there is a paucity of human data. Material and Methods: This is a secondary cohort analysis of the 50-year follow-up of the Auckland Steroid Trial (1969-1974) comparing antenatal exposure to corticosteroids or placebo. Participants whose mothers took part in the placebo-controlled randomized trial of antenatal corticosteroids completed a questionnaire reporting reproductive outcomes at 50 years of age. The main outcome was at least one pregnancy ≥20 weeks or fathered at least one pregnancy ≥20 weeks. Additional outcomes included a number of pregnancies or fathered pregnancies ≥20 weeks, outcomes relating to female reproductive lifespan (including age at menarche and menopause), and outcomes relating to their offspring (including birthweight and gestation). Results: Of 917 eligible participants, 415 (45% of eligible) completed the questionnaire at a mean (SD) age of 49.3 (1.0) years. The proportion of participants who had experienced at least one pregnancy ≥20 weeks or fathered at least one pregnancy ≥20 weeks was similar in betamethasone and placebo-exposed groups (163/217 [75%] vs. 136/190 [72%]; RR 1.08, (95% CI 0.95 to 1.22); p = 0.23). Participants exposed to betamethasone had a slightly higher number of pregnancies or fathered pregnancies ≥20 weeks compared to those exposed to placebo (mean 1.89 vs. 1.60; marginal mean difference 0.20, (95% CI 0.03-0.37); p = 0.03). Other outcomes, including female reproductive lifespan and offspring-related outcomes, were similar in both randomized groups. There were also no differences in any outcomes between those born preterm and those born at term. Conclusions: Antenatal exposure to corticosteroids appears to have no clinically important effect on reproductive outcomes to 50 years. (© 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)
Databáze:	MEDLINE
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