title: Impact of Antenatal Glucocorticoid Therapy and Risk of Preterm Delivery on Intelligence in Term-Born Children.
abstract: BACKGROUND
  Women at risk of preterm delivery are routinely treated with synthetic glucocorticoids (sGCs). Although this therapy substantially reduces neonatal morbidity, concerns remain whether sGC excess may disrupt neurodevelopmental trajectories underlying cognitive functioning.
  
  
  OBJECTIVE
  The present study is the first to disentangle direct effects of antenatal sGC treatment on possible long-term cognitive disadvantages from those of pregnancy complications and prematurity.
  
  
  METHODS
  This cross-sectional study included a mixed-sex cohort of 222 term-born children (aged 6-11 years) consisting of three groups: children of mothers admitted to hospital for threatening preterm delivery who had been treated (n = 97) or untreated (n = 36) with sGCs, and controls without pregnancy complications (n = 89).
  
  
  METHODS
  Antenatal sGC treatment consisted of single courses with dexamethasone or betamethasone.
  
  
  METHODS
  Psychometric intelligence was assessed using a German adaption of Cattell's Culture Fair Test.
  
  
  RESULTS
  Children born to mothers at risk for preterm delivery scored, on average, 6-7 IQ points below children of mothers without pregnancy complications, irrespective of antenatal sGC treatment. Compared to females, boys were found to be more susceptible to cognitive disadvantages associated with maternal risk for preterm delivery.
  
  
  CONCLUSIONS
  Our data indicate that conditions related to a threatening preterm delivery rather than antenatal sGC treatment per se are associated with long-term decreases in the child's intelligence. Although these findings imply that a single course of sGC therapy does not aggravate long-term cognitive deficits, they highlight the need for interventions to reduce the detrimental consequences of distress induced by a threatening preterm delivery.
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Nina
authors.initials: N
authors.lastname: Alexander
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Franziska
authors.initials: F
authors.lastname: Rosenlöcher
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Lucia
authors.initials: L
authors.lastname: Dettenborn
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Tobias
authors.initials: T
authors.lastname: Stalder
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Linke
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Distler
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Joachim
authors.initials: J
authors.lastname: Morgner
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Miller
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Matthias
authors.initials: M
authors.lastname: Kliegel
authors.affiliation: Department of Psychology (N.A.), Faculty of Human Sciences, Medical School Hamburg, Hamburg, Germany; Department of Psychology (N.A., F.R., T.S., R.M., C.K.), Faculty of Science, Technische Universität Dresden, Germany; Department of Medical Psychology (L.D.), University Medical Center Hamburg-Eppendorf, Germany; Department of Neuropsychology and Clinical Psychology (J.L.), Psychological Institute, Johannes-Gutenberg University of Mainz, Germany; Department of Gynaecology and Obstetrics (W.D.), Medical Center, Technische Universität Dresden, Germany; Dresden Neustadt Hospital (J.M.), Germany; Department of Psychology (M.K.), Cognitive Aging Lab, University of Geneva, Switzerland.
authors.forename: Clemens
authors.initials: C
authors.lastname: Kirschbaum
mesh_terms: D000328:Adult; D001623:Betamethasone / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D003071:Cognition / Q000187:drug effects; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003907:Dexamethasone / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007360:Intelligence / Q000187:drug effects*; D007361:Intelligence Tests; D008297:Male; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects / Q000523:psychology*; D012306:Risk; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced; D047929:Term Birth
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone; D001623:Betamethasone