title: Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism.
abstract: OBJECTIVE
  Animal studies have demonstrated long-term effects of in utero glucocortcoid exposure on vascular development and glucose metabolism. We hypothesized that there would be a similar impact in humans.
  
  
  METHODS
  One hundred and two young adults born preterm aged 23 to 28 years, with prospective data collection from birth, and 95 adults born term after uncomplicated pregnancies underwent cardiovascular MRI. We compared cardiac and aortic structure and function, as well as cardiovascular risk profile, in a nested case-control study of 16 participants exposed to antenatal steroids and 32 who were not, but with otherwise similar perinatal care. Outcomes were compared with normal ranges in those born term.
  
  
  RESULTS
  Adults whose mothers had received antenatal steroids had decreased ascending aortic distensibility (9.88 ± 3.21 vs 13.62 ± 3.88 mm Hg(-1) × 10(3), P = .002) and increased aortic arch pulse wave velocity (5.45 ± 1.41 vs 4.47 ± 0.91 m/s, P = .006). The increase in stiffness was equivalent to that of term adults a decade older. Those who had in utero exposure to antenatal steroids also had significant differences in homeostatic model assessments for β-cell function (P = .010), but in multiple regression analysis this did not explain the impact of steroids on aortic function.
  
  
  CONCLUSIONS
  Antenatal glucocorticoid exposure in preterm infants is associated with increased aortic arch stiffness and altered glucose metabolism in early adulthood.
authors.affiliation: Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.
authors.forename: Brenda A
authors.initials: BA
authors.lastname: Kelly
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Lewandowski
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Worton
authors.forename: Esther F
authors.initials: EF
authors.lastname: Davis
authors.forename: Merzaka
authors.initials: M
authors.lastname: Lazdam
authors.forename: Jane
authors.initials: J
authors.lastname: Francis
authors.forename: Stefan
authors.initials: S
authors.lastname: Neubauer
authors.forename: Alan
authors.initials: A
authors.lastname: Lucas
authors.forename: Atul
authors.initials: A
authors.lastname: Singhal
authors.forename: Paul
authors.initials: P
authors.lastname: Leeson
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000187:drug effects*; D001783:Blood Flow Velocity / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure / Q000187:drug effects; D016022:Case-Control Studies; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000187:drug effects*; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000175:diagnosis*; D014655:Vascular Resistance / Q000187:drug effects; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D005938:Glucocorticoids