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453 Repeat Courses of Antenatal Corticosteroids for Preterm Birth and Risk for Metabolic Syndrome in Young Adulthood
  1. H Norberg1,
  2. J Stålnacke2,
  3. R Diaz Heijtz2,
  4. AC Smedler3,
  5. H Forssberg2,
  6. M Norman1
  1. 1Department of Clinical Science, Intervention and Technology
  2. 2Department of Women’s and Children’s Health, Karolinska Institutet
  3. 3Department of Psychology, Stockholm University, Stockholm, Sweden

Abstract

Background Preterm birth is associated with later hypertension and diabetes. One explanation for this association could be that exposure to antenatal corticosteroids (ACS), especially if repeated, induce adverse long-term effects. There are no data on whether repeat courses of ACS are associated with health problems later in life. The aim of this study was to assess whether repeat courses of ACS correlate to metabolic syndrome later in life.

Methods In a population-based cohort we measured BMI, blood pressure, arterial stiffness, blood lipids and glucose tolerance in 58 subjects (36 boys, age 14 to 26 years) exposed to 2–9 weekly courses of antenatal betamethasone. Subjects exposed to a single course (n=25, 14 boys) and unexposed subjects (n=44, 25 boys) were included as comparison groups.

Results As compared to unexposed controls, subjects exposed to repeat courses of ACS did not differ in BMI (mean difference 0.6kg/m2, p=0.5), mean systolic or diastolic blood pressure (mean diff 1mmHg, p=0.78–0.83), arterial stiffness assessed by pulse wave analysis (mean diff 0.1%, p=0.50), triglyceride (mean diff 0.1mmol/L), total cholesterol (mean diff 0mmol/L), LDL/HDL ratio (mean diff 0.1), Lipoprotein(a) (mean diff. 61mg/L), ApolipoproteinB/ApolipoproteinA1 ratio (mean diff 0.01), (p=0.33–0.91) or glucose tolerance assessed by HOMA-index (mean diff 0, p=0.84). Subjects exposed to a single course of ACS did not differ from the other groups in any of the variables above.

Conclusions Repeat courses of ACS do not correlate to metabolic syndrome in young adulthood. This observation has clinical implications for the ongoing discussion about safety of antenatal steroids.

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