title: Repeated course antenatal steroids, inflammation gene polymorphisms, and neurodevelopmental outcomes at age 2.
abstract: OBJECTIVE
  We sought to evaluate the interaction between repeated-course antenatal corticosteroids and inflammation gene polymorphisms with neurodevelopmental outcomes at age 2 years.
  
  
  METHODS
  We conducted nested case-control analysis of a randomized controlled trial of single- vs repeated-course antenatal corticosteroids. Cases had mental and/or psychomotor delay at age 2 years. Controls had normal neurodevelopment. Previous analyses of 125 cases and 147 controls identified 4 inflammation gene polymorphisms associated with neurodevelopmental delay at age 2 years.
  
  
  RESULTS
  The interaction between repeated-course corticosteroids and the interleukin (IL)-6 -174 genotype with neurodevelopmental delay was significant (P = .046). The IL-6 -174 GG genotype was associated with neurodevelopmental delay at age 2 years in the single-course corticosteroid group (odds ratio, 6.47; 95% confidence interval, 1.86-22.50). Exposure to repeated-course antenatal corticosteroids abrogated this genotype effect (odds ratio, 1.30; 95% confidence interval, 0.48-3.54). Results were unchanged after controlling for potential confounders.
  
  
  CONCLUSIONS
  Repeated-course antenatal steroids may reduce the increased risk of neurodevelopmental delay at age 2 years associated with IL-6 -174 GG genotype.
authors.affiliation: Departments of Obstetrics and Gynecology at the University of Utah, Salt Lake City, UT 84132, USA. erin.clark@hsc.utah.edu
authors.forename: Erin A S
authors.initials: EA
authors.lastname: Clark
authors.forename: Lisa
authors.initials: L
authors.lastname: Mele
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Catherine Y
authors.initials: CY
authors.lastname: Spong
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
authors.forename: Alan
authors.initials: A
authors.lastname: Peaceman
authors.forename: Jay D
authors.initials: JD
authors.lastname: Iams
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Leveno
authors.forename: Margaret
authors.initials: M
authors.lastname: Harper
authors.forename: Steve N
authors.initials: SN
authors.lastname: Caritis
authors.forename: Brian M
authors.initials: BM
authors.lastname: Mercer
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Susan M
authors.initials: SM
authors.lastname: Ramin
authors.forename: Marshall
authors.initials: M
authors.lastname: Carpenter
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D002490:Central Nervous System / Q000187:drug effects* / Q000254:growth & development*; D002657:Child Development / Q000187:drug effects*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007249:Inflammation / Q000235:genetics; D015850:Interleukin-6 / Q000235:genetics*; D008297:Male; D020641:Polymorphism, Single Nucleotide; D016032:Randomized Controlled Trials as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D015850:Interleukin-6