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Associations of antenatal glucocorticoid exposure with mental health in children

Published online by Cambridge University Press:  28 January 2019

Elina Wolford Open the ORCID record for Elina Wolford [Opens in a new window] ,
Marius Lahti-Pulkkinen ,
Polina Girchenko ,
Jari Lipsanen ,
Soile Tuovinen ,
Jari Lahti ,
Kati Heinonen ,
Esa Hämäläinen ,
Eero Kajantie  and
Anu-Katriina Pesonen
...Show all authors
Elina Wolford*
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Marius Lahti-Pulkkinen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
Polina Girchenko
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Jari Lipsanen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Soile Tuovinen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Jari Lahti
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland Folkhälsan Research Centre, Helsinki, Finland
Kati Heinonen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Esa Hämäläinen
Affiliation:
Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland
Eero Kajantie
Affiliation:
National Institute for Health and Welfare, Helsinki, Finland Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
Anu-Katriina Pesonen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Pia M. Villa
Affiliation:
Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Hannele Laivuori
Affiliation:
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
Rebecca M. Reynolds
Affiliation:
University/British Heart Foundation Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
Katri Räikkönen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
*
Author for correspondence: Elina Wolford, E-mail: elina.wolford@helsinki.fi
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Abstract

Background

Synthetic glucocorticoids, to enhance fetal maturation, are a standard treatment when preterm birth before 34 gestational weeks is imminent. While morbidity- and mortality-related benefits may outweigh potential neurodevelopmental harms in children born preterm (<37 gestational weeks), this may not hold true when pregnancy continues to term (⩾37 gestational weeks). We studied the association of antenatal betamethasone exposure on child mental health in preterm and term children.

Methods

We included 4708 women and their children, born 2006–2010, from the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction Study with information on both antenatal betamethasone treatment and child mental and behavioral disorders from the Finnish Hospital Discharge Register from the child's birth to 31 December 2016. Additional follow-up data on mother-reported psychiatric problems and developmental milestones were available for 2640 children at 3.5 (s.d. = 0.07) years-of-age.

Results

Of the children, 187 were born preterm (61 betamethasone-exposed) and 4521 at term (56 betamethasone-exposed). The prevalence of any mental and behavioral, psychological development, emotional and behavioral, and comorbid disorders was higher in the betamethasone-exposed, compared to non-exposed children [odds ratio 2.76 (95% confidence interval 1.76–4.32), 3.61 (2.19–5.95), 3.29 (1.86–5.82), and 6.04 (3.25–11.27), respectively]. Levels of psychiatric problems and prevalence of failure to meet the age-appropriate development in personal-social skills were also higher in mother-reports of betamethasone-exposed children. These associations did not vary significantly between preterm and term children.

Conclusions

Antenatal betamethasone exposure may be associated with mental health problems in children born preterm and in those who end up being born at term.

Keywords

Betamethasonedevelopmental milestonesglucocorticoidsmental healthpsychiatric problems
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 2 , January 2020 , pp. 247 - 257
Copyright
Copyright © Cambridge University Press 2019

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