title: A psychoneuroimmunologic examination of cumulative perinatal steroid exposures and preterm infant behavioral follow-up.
abstract: OBJECTIVE
  This study's aim was to explore relationships between preterm infant behavioral outcomes and maternal/infant glucocorticoid (dexamethasone [DEX]) treatments using a psychoneuroimmunologic approach. Research questions were (a) do relationships exist between infant cumulative perinatal steroid (PNS) exposure and child behavioral problems? and (b) do maternal/infant characteristics (e.g., immune markers and biophysiologic stressors) influence these relationships?
  
  
  METHODS
  The convenience sample comprised 45 mother-child dyads in which the children (mean age 8 years ± 2.3) had been born at a mean postconceptional age of 28 weeks (± 4.2). We used the Child Behavior Checklist (CBCL) to assess behavior, the Clinical Risk Index for Babies (CRIB) to score stress at birth, and retrospective record review to identify additional perinatal factors (PNS dosage, sepsis, and maternal and infant complete blood counts near delivery).
  
  
  RESULTS
  Children were dichotomized into high (> 0.2 mg/kg; n = 20) versus low-no (≤0.2 mg/kg; n = 25) PNS exposure groups. Significant relationships existed between CBCL Total Problems score and sepsis, PNS exposure, timing of initial PNS, and infant length percentile at discharge. Competence problems were significantly associated with PNS, neonatal intensive care unit (NICU) infant length percentile, CRIB score, sepsis, retinopathy of prematurity, hearing deficit, and immunity markers (i.e., maternal lymphocyte percentage and infant band/seg ratio). Children in the higher PNS group exhibited more behavioral problems (e.g., withdrawn, attention, conduct, social, and rule breaking problems), but there were no significant differences. The findings are reassuring regarding long-term effects of this PNS dose on preterm infant behavioral outcomes.
authors: Department of Pediatrics, Neonatology, David Geffen School of Medicine at University of California, Los Angeles, 90096, USA. ipurdy@mednet.ucla.edu
authors: Isabell B
authors: IB
authors: Purdy
authors: Lynne
authors: L
authors: Smith
authors: Dorothy
authors: D
authors: Wiley
authors: Lina
authors: L
authors: Badr
mesh_terms: D000328:Adult; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D018730:Infant Behavior; D007231:Infant, Newborn; D007234:Infant, Premature; D018811:Maternal Exposure; D011247:Pregnancy; D011598:Psychoneuroimmunology
chemical_list: D005938:Glucocorticoids