Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children.
Antenatal corticosteroid therapy substantially improves the survival rate of preterm infants, with few side effects. Higher blood pressure in adulthood has been described in several animal species after exposure to antenatal corticosteroids, but there are no similar reports in humans. The objective of the present study was to determine the relationship between exposure to antenatal corticosteroid therapy and blood pressure at 14 years of age. This was a cohort study of 210 preterm survivors with birthweights of <1501 g born in the Royal Women's Hospital, Melbourne, between 1 January 1977 and 31 March 1982. Blood pressure was measured in 177 subjects (84.3%) at 14 years of age with a standard mercury sphygmomanometer. Children exposed to antenatal corticosteroids (n=89) had higher systolic and diastolic blood pressures than those not exposed to corticosteroids (n=88) [mean difference (95% confidence interval) (mmHg): systolic, 4.1 (0.1-8.0); diastolic, 2.8 (0.05-5.6)]. However, few had blood pressure in the hypertensive range. It is concluded that antenatal corticosteroid therapy is associated with higher systolic and diastolic blood pressures in adolescence, and might lead to clinical hypertension in survivors well beyond birth.
Doyle
L W
LW
Department of Obstetrics and Gynaecology and Department of Paediatrics, University of Melbourne, Parkville, Victoria 3052, Australia. l.doyle@obgyn.rwh.unimelb.edu.au
Ford
G W
GW
Davis
N M
NM
Callanan
C
C
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000704:Analysis of Variance; D001794:Blood Pressure / Q000187:drug effects*; D015986:Confounding Factors, Epidemiologic; D003907:Dexamethasone / Q000494:pharmacology; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000494:pharmacology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D011297:Prenatal Exposure Delayed Effects
D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D003907:Dexamethasone