Gestational exposure to systemic glucocorticoids linked to incident kidney disease in childhood: Study

The potential effects of antenatal glucocorticoid exposure on children's health are unclear. We examined the association between gestational exposure to maternal systemic glucocorticoids (SG) and the risk of developing chronic kidney disease (CKD) in childhood. Cox proportional hazard models with stabilized inverse probability of treatment weighting and robust sandwich estimator were used to estimate the average association between SG and incident CKD after adjustment for offspring characteristics (aHR). Results: Among 23,363 singleton-born children, gestational SG exposure was significantly associated with a higher risk of childhood CKD (aHR, 1.69 [95% CI, 1.01-2.84]).

Stratified analyses showed stronger associations between SG and childhood CKD within the strata of birth <37 weeks gestational age (aHR, 2.38 [95% CI, 1.19-4.78]), male sex (aHR, 1.89 [95% CI, 1.00-3.55]), gestational exposure in the second trimester (aHR, 6.70 [95% CI, 2.17-20.64]), and total dose >24 mg hydrocortisone equivalent (aHR, 1.91 [95% CI, 1.05-3.47). Study was limited to the Taiwan healthcare delivery system and childhood CKD events through age 10 years. The findings of this study suggest that gestational exposure to systemic glucocorticoids is associated with the occurrence of kidney disease in childhood. If these findings are confirmed, they may inform clinicians who are considering prescribing SG during pregnancy.

Reference:

Tain YL, Li LC, Kuo HC, Hsu CN. Gestational Exposure to Maternal Systemic Glucocorticoids and Childhood Risk of CKD. Am J Kidney Dis. 2024 Mar 11:S0272-6386(24)00669-3. doi: 10.1053/j.ajkd.2024.01.523. Epub ahead of print. PMID: 38479460.