Potential risks of antenatal steroids highlighted in new study

Two new studies published by The BMJ recently examine the potential health risks for infants of giving steroid drugs to women who are at risk of giving birth early.

Corticosteroids are known to help increase the chance of a baby born early surviving and having fewer health problems. Ideally, they should be given before 34 weeks of pregnancy and within approximately one week of birth. But their effects on later childhood health are less well understood, particularly when administration is “mistimed” and infants are born at term.

Two studies set out to fill this knowledge gap.

The first is based on data from the National Health Insurance Research Database (NHIRD) in Taiwan for nearly 2 million children born between 2008 and 2019. It shows that exposure to antenatal corticosteroids compared with no exposure is associated with an increased risk of serious infection, including sepsis and pneumonia, during the first 12 months of life.

Further analyses suggest the increase in risk of serious childhood infection is greater for infants born at term than for those born preterm.

The second study, based on data from seven randomised controlled trials and 10 population studies involving 1.6 million infants born since 2000, shows that around 40% of infants treated with antenatal corticosteroids are born at term.

For these children, exposure to antenatal corticosteroids was associated with an increased risk of short and long term health issues, such as admission to neonatal intensive care, breathing problems, and reduced growth.

Reference: The BMJ, Antenatal corticosteroids and longer term outcomes, doi: 10.1136/bmj.p1722