title: Prenatal glucocorticoid treatment and later mental health in children and adolescents.
abstract: BACKGROUND
  Animal studies demonstrate a clear link between prenatal exposure to glucocorticoids (GC) and altered offspring brain development. We aim to examine whether prenatal GC exposure programs long-term mental health in humans.
  
  
  METHODS
  Using propensity-score-matching, children prenatally exposed to synthetic glucocorticoids (sGC), n=37, and controls, n=185, were balanced on important confounders related to sGC treatment--gestational age and pre-pregnancy BMI. We also used mixed-effects modeling to analyse the entire cohort--matching each sGC case, n=37, to all possible controls, n=6079, on gestational age and sex. We obtained data from the Northern Finland Birth Cohort 1986 at four waves--pregnancy, birth, 8 and 16 years. Data on pregnancy and birth outcomes came from medical records. Mental health was assessed at 8 years by teachers with the Rutter B2 scale, and at 16 years by parents with the Strengths and Weaknesses of ADHD symptoms and Normal behavior (SWAN) scale and adolescents by the Youth Self-Report (YSR) scale.
  
  
  RESULTS
  Prenatal sGC treatment was consistently associated with adverse mental health in childhood and adolescence, as shown by both the propensity-score method and mixed-effects model. Using the propensity-score-matched subsample, linear multiple regression showed prenatal sGC was significantly linked with general psychiatric disturbance (B=8.34 [95% CI: .23-16.45]) and inattention (B= .97 [95% CI: .16-1.80]) at 8 years after control for relevant confounders. Similar findings were obtained at 16 years, but did not reach statistical significance. Mediation by birthweight/placental weight was not detected.
  
  
  CONCLUSIONS
  This study is the first to prospectively investigate the long-term associations between prenatal exposure to sGC treatment and mental health in children and adolescents. We report an association between prenatal exposure to sGC and child mental health, supportive of the idea that sGC has a programming effect on the fetal brain.
authors.affiliation: Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
authors.forename: Natasha
authors.initials: N
authors.lastname: Khalife
authors.forename: Vivette
authors.initials: V
authors.lastname: Glover
authors.forename: Anja
authors.initials: A
authors.lastname: Taanila
authors.forename: Hanna
authors.initials: H
authors.lastname: Ebeling
authors.forename: Marjo-Riitta
authors.initials: MR
authors.lastname: Järvelin
authors.forename: Alina
authors.initials: A
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018811:Maternal Exposure; D008603:Mental Health; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors
chemical_list: D005938:Glucocorticoids