Poster Session 1
Category: Prematurity
Poster Session 1
Amir Snir, MD
Soroka University Medical Center
omer, HaDarom, Israel
Omri Zamstein, MD (he/him/his)
Physician
Soroka University Medical Center
Soroka University Medical Center, 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
Antenatal corticosteroids (ACS) are routinely given to pregnancies at risk for preterm birth due to their known benefits in reducing neonatal morbidity and mortality. However, predicting preterm birth remains difficult, and many treated pregnancies ultimately deliver at term. We assessed the risk of childhood neurological morbidity among term-born infants following ACS exposure.
Study Design:
A population-based cohort study was conducted at a tertiary referral center, including singleton term births. Infants were classified by exposure to ACS administered before 34 weeks’ gestation for suspected preterm labor. Neurological conditions during childhood were identified through community and hospital medical records. Cumulative incidence was estimated using Kaplan–Meier analysis, and Cox proportional hazards models were used to adjust for confounders.
Results:
Among 182,626 term births, 2,093 neonates (1.1%) were exposed to ACS before 34 weeks’ gestation. These pregnancies had higher rates of diabetes mellitus, hypertensive disorders, cesarean delivery, and earlier gestational age at birth (Table). During follow-up, 30,616 children were diagnosed with neurological morbidity. The incidence rate was significantly higher in the exposed group (29.8 vs. 20.0 per 1,000 person-years; Kaplan–Meier log-rank p< 0.001; Figure). In a multivariable Cox model, adjusting for maternal age, ethnicity, mode of delivery, gestational complications, and gestational age, ACS exposure remained independently associated with increased neurological morbidity (aHR=1.11; 95% CI 1.05–1.17; p< 0.001). This association was also evident in a subgroup analysis restricted to early-term births (37+0 to 38+6 weeks), with an aHR of 1.17 (95% CI 1.09–1.23; p< 0.001).
Conclusion:
ACS exposure before 34 weeks was associated with increased neurological morbidity in children born at term. While essential in managing threatened preterm birth, these findings raise concern for long-term effects when delivery occurs at term, supporting the need for further research to guide clinical decision-making.