Poster Session 1
Category: Prematurity
Poster Session 1
Sapir Ellouk, MD, MPH (she/her/hers)
Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University, 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
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 administered to reduce complications associated with preterm birth; however, their long-term effects on the endocrine system in offspring remain under investigation, particularly concerns regarding neonatal hypoglycemia. We investigated the long-term endocrine morbidity of preterm offspring exposed to ACS prior to 34 weeks of gestation.
Study Design:
We conducted a population-based cohort study of singleton preterm deliveries between 1991 and 2021. Long-term endocrine morbidity was compared between offspring exposed to ACS before 34 weeks of gestation and unexposed counterparts, using linked community and hospitalization databases. Cumulative incidence was assessed with Kaplan–Meier survival analysis, and a Cox proportional hazards model was used to adjust for potential confounders.
Results:
The study included 13,580 preterm deliveries, of which 1,538 (11.3%) offspring were exposed to ACS. Both the overall incidence of endocrine morbidity per 1,000 person-years (Table) and the cumulative incidence over time (log-rank p< 0.001; Figure) were significantly higher among ACS-exposed children compared to unexposed children. In addition, ACS-exposed offspring had significantly higher rates of hypoglycemia and adrenal disorders (p < 0.001 for both; Table). In a Cox regression model adjusted for maternal age, gestational age, diabetes mellitus, hypertensive disorders, and mode of delivery, ACS exposure before 34 weeks was independently associated with an increased risk of long-term endocrine morbidity (aHR 1.35; 95% CI, 1.18–1.54; p< 0.001).
Conclusion:
ACS exposure before 34 weeks of gestation may be associated with an increased risk of long-term endocrine morbidity in preterm offspring. However, the possibility of indication bias cannot be excluded. Further studies are warranted to confirm these findings and clarify the underlying mechanisms.