Antenatal Glucocorticoid Exposure and Long-Term Alterations in Aortic Function and Glucose Metabolism

Pediatrics, 05/11/2012

Kelly BA et al. – Antenatal glucocorticoid exposure in preterm infants is associated with increased aortic arch stiffness and altered glucose metabolism in early adulthood.

Methods

  • One hundred and two young adults born preterm aged 23 to 28 years, with prospective data collection from birth, and 95 adults born term after uncomplicated pregnancies underwent cardiovascular MRI.
  • The authors compared cardiac and aortic structure and function, as well as cardiovascular risk profile, in a nested case-control study of 16 participants exposed to antenatal steroids and 32 who were not, but with otherwise similar perinatal care.
  • Outcomes were compared with normal ranges in those born term.

Results

  • Adults whose mothers had received antenatal steroids had decreased ascending aortic distensibility and increased aortic arch pulse wave velocity.
  • The increase in stiffness was equivalent to that of term adults a decade older.
  • Those who had in utero exposure to antenatal steroids also had significant differences in homeostatic model assessments for beta-cell function (P = .010), but in multiple regression analysis this did not explain the impact of steroids on aortic function.

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