Poster Session 4
Category: Epidemiology
Poster Session 4
Daniel Ling, MD
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University
Beer-Sheva, HaDarom, Israel
Tamar Wainstock, PhD (she/her/hers)
Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev
Beer Sheva, HaDarom, Israel
.jpeg.jpg "Eyal Sheiner, MD, PhD photo")
Eyal Sheiner, MD, PhD
Deichmann Lerner Full Professor of Obstetrics & Gynecology; Chairman of the Division of OBY&GYN
Soroka University Medical Center, Faculty of Health Sciences, Ben‑Gurion University of the Negev
beer sheva, HaDarom, Israel
.jpg "Gali Pariente, MD photo")
Gali Pariente, MD
Acting director of Fetal Maternal Unit B Division of Obstetrics and Gynecology
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University
beer sheva, HaDarom, Israel
Antenatal corticosteroids (ACS) are widely used to reduce neonatal morbidity in pregnancies at risk of preterm delivery. However, concerns persist regarding potential long-term harms. We aimed to evaluate the association between ACS exposure before 34 weeks of gestation and the risk of childhood malignancy.
Study Design:
A population-based retrospective cohort study was conducted using data from a single tertiary medical center between the years 1991 and 2021. The cohort included singleton infants, whose mothers did or did not receive ACS prior to 34 weeks. Diagnoses of childhood malignancy were identified through linkage with community clinics and hospital records. Kaplan-Meier survival curve was used to compare the incidence of long-term malignancy between the study groups. A Cox proportional hazards model was used to control for confounders.
Results:
The study included 196,377 singleton births, of which 3,634 (1.9%) were exposed to ACS before 34 weeks. Childhood malignancy was diagnosed in 9 (0.25%) of the exposed group and in 438 (0.23%) of the unexposed group (p = 0.798). The cumulative incidence of malignancy did not significantly differ between groups (Log-Rank p = 0.055, Figure). However, in a Cox proportional hazards model adjusting for gestational age at birth and ethnicity, ACS exposure was independently associated with a modest but statistically significant increased risk of childhood malignancy (adjusted HR: 1.42, 95% CI: 1.014–1.979, p = 0.041).
Conclusion:
In our population, ACS exposure before 34 weeks was associated with a small increase in childhood malignancy risk, regardless of gestational age at birth. While ACS remains essential in managing threatened preterm birth, this association may partly reflect indication bias, as more vulnerable fetuses are more likely to receive treatment. Further research is warranted to clarify long-term outcomes and guide clinical decision-making.