[Antenatal exposure to corticosteroids for fetal lung maturation and its repercussion on weight, length and head circumference in the newborn infant].
OBJECTIVE
To study the effects of antenatal corticosteroids treatment to promote fetal lung maturation, on fetal growth, depending on the number of the courses administered.


METHODS
The study was based on data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), analysing a sample of 29,557 singleton liveborn infants without congenital defects. An stratified analysis by gestational age was performed to compare the weight, length and head circumference at birth, in the exposed and unexposed infants to dexamethasone/betamethasone. To control confounding factors (year of birth, maternal age, gestational age, parity, maternal smoking and/or alcohol consumption, gestational diabetes, non-gestational diabetes and other maternal chronic diseases) we used a general linear model with random effects, being the randomised variable the place of birth.


RESULTS
The exposure to more than one course of antenatal corticosteroids resulted in a significant reduction of birth weight, length and head circumference in singleton preterm infants. The birth weight decreased by 22% (p < 0.0001), the length 5% (p = 0.002) and the head circumference 6% (p = 0.0005). The treatment with only one course reduced also significantly the weight and length but not the head circumference. In addition, we observed a significant interaction between the treatment and gestational age at birth indicating that the effect of corticosteroids is stronger in the most premature babies.


CONCLUSIONS
In this retrospective analysis, the antenatal exposure to corticosteroids to promote fetal maturation is associated with diminished weight, length and head circumference in the premature newborn infant. This negative effect was greater in those premature babies exposed to multiple courses.
Rodríguez-Pinilla
Elvira
E
Centro de Investigación sobre Anomalías Congénitas (CIAC), Sección de Teratología Clínica y Servicio de Información sobre Teratógenos (SITTE), Instituto de Salud Carlos III, Madrid, España. e.rodríguez-pinilla@isciii.es
Prieto-Merino
David
D
Dequino
Griselda
G
Mejías
Consuelo
C
Fernández
Paloma
P
Martínez-Frías
María-Luisa
ML
D000328:Adult; D000886:Anthropometry; D001724:Birth Weight / Q000187:drug effects*; D001827:Body Height / Q000187:drug effects; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000187:drug effects / Q000254:growth & development*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced*
D005938:Glucocorticoids