Abstract
The objective of this study was to synthesize the body of knowledge on the association between ACS exposure for risk of preterm birth and brain development in infants ultimately born late preterm and term. Three databases and eight conference proceedings were systematically searched (1972ā2021). Selection criteria included ACS administration for risk of preterm delivery, cohort of late preterm and term infants, and assessment of brain development. Data on study characteristics, ACS administration, and neurological outcomes were extracted and qualitatively synthesized according to themes. Neurological outcomes of the included studies (nā=ā27) were grouped into four themes. The most common adverse outcomes were reduced neonatal head circumference, structural cortical differences on MRI, increased prevalence of psychiatric problems, and increased risk of neurodevelopmental delays in ACS-exposed late preterm and term infants. Our scoping review demonstrated that ACS exposure for risk of preterm delivery may have important neurological implications in infants ultimately born late preterm and term. Given that the existing research is at serious risk for bias, further research that accounts for confounders such as preterm labor, maternal stress, and the number of ACS courses is needed to better establish the long-term neurological effects of ACS on late preterm and term infants.
Impact
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Due to the difficulty in predicting preterm birth, approximately 40% of fetuses exposed to antenatal corticosteroids (ACS) are born at term (ā„37 weeksā gestation).
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This scoping review summarizes the knowledge on the association between ACS exposure for risk of preterm birth and brain development in late preterm and term infants.
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The majority of studies reported that ACS exposure was associated with adverse brain development outcomes across various domains, such as reduced neonatal head circumference, cortical differences on MRI, and increased prevalence of psychiatric problems and neurodevelopmental delays in late preterm and term infants.
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Data availability
All data analyzed during this study are included in this review and itsĀ Supplemental Information file.
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Acknowledgements
The authors would like to thank librarian Ms. Genevieve Gore for assistance with the search strategy and epidemiologist Dr. Olga Basso for assistance with the risk of bias assessment.
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Each author has met the Pediatric Research authorship requirements. J.G. conceived the review. E.B.S., M.L.S., and J.G. participated in the development of the design of the review. E.B.S. carried out the searches. E.B.S. and M.L.S. reviewed the studies. E.B.S. wrote the draft manuscript. E.B.S., M.L.S., A.-M.M., and J.G. contributed to the development and finalization of the paper.
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Sarid, E.B., Stoopler, M.L., Morency, AM. et al. Neurological implications of antenatal corticosteroids on late preterm and term infants: a scoping review. Pediatr Res 92, 1225ā1239 (2022). https://doi.org/10.1038/s41390-022-02135-3
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DOI: https://doi.org/10.1038/s41390-022-02135-3
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