Antenatal corticosteroids and cardiometabolic outcomes in adolescents born with very low birth weight

Pediatr Res. 2017 Oct;82(4):697-703. doi: 10.1038/pr.2017.133. Epub 2017 Jun 21.

Abstract

BackgroundExposure to antenatal corticosteroids (ANCS) is associated with adverse cardiometabolic outcomes in animal models; however, long-term outcomes in clinical studies are not well characterized. We hypothesized that exposure to ANCS would be associated with markers of increased cardiometabolic risk in adolescents born with very low birth weight (VLBW).MethodsIn an observational cohort of 186 14-year-old adolescents born with VLBW, we measured resting blood pressure (BP), BP response to cold, ambulatory BP, and anthropometrics; performed dual-energy X-ray absorptiometry; and analyzed blood samples for uric acid, cholesterol, glycated hemoglobin, and high-sensitivity C-reactive protein. Multivariate analyses were used to evaluate associations with ANCS, adjusting for race, sex, and maternal hypertensive pregnancy.ResultsThere were no ANCS group differences in BP measures or blood biomarkers. Compared with adolescents unexposed to ANCS, those exposed to ANCS were taller (exposed-unexposed mean difference 3.1 cm (95% confidence interval (CI) 0.7, 5.5)) and had decreased waist-to-height ratio (exposed-unexposed mean difference -0.03 (95% CI -0.058, -0.002)). Males exposed to ANCS had lower total cholesterol (exposed-unexposed mean difference -0.54 mmol/l (95%CI -0.83, -0.06)).ConclusionAmong adolescents born with VLBW, ANCS exposure was not associated with markers of increased cardiometabolic risk.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / adverse effects*
  • Biomarkers / blood
  • Birth Weight
  • Blood Pressure
  • Body Composition
  • C-Reactive Protein / analysis
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / physiopathology
  • Cholesterol / blood
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Least-Squares Analysis
  • Linear Models
  • Logistic Models
  • Male
  • Metabolic Diseases / blood
  • Metabolic Diseases / chemically induced*
  • Metabolic Diseases / diagnosis
  • Metabolic Diseases / physiopathology
  • Multivariate Analysis
  • Odds Ratio
  • Risk Factors
  • Uric Acid / blood

Substances

  • Adrenal Cortex Hormones
  • Biomarkers
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human
  • Uric Acid
  • C-Reactive Protein
  • Cholesterol