Antenatal corticosteroids and cardiometabolic outcomes in adolescents born with very low birth weight

Abstract

Background: Exposure to antenatal corticosteroids (ANCS) is associated with adverse cardiometabolic outcomes in animal models; however, long-term outcomes in clinical studies are not well characterized. We hypothesized that exposure to ANCS would be associated with markers of increased cardiometabolic risk in adolescents born with very low birth weight (VLBW). Methods: In an observational cohort of 186 14-year-old adolescents born with VLBW, we measured resting blood pressure (BP), BP response to cold, ambulatory BP, and anthropometrics; performed dual-energy X-ray absorptiometry; and analyzed blood samples for uric acid, cholesterol, glycated hemoglobin, and high-sensitivity C-reactive protein. Multivariate analyses were used to evaluate associations with ANCS, adjusting for race, sex, and maternal hypertensive pregnancy. Results: There were no ANCS group differences in BP measures or blood biomarkers. Compared with adolescents unexposed to ANCS, those exposed to ANCS were taller (exposed-unexposed mean difference 3.1 cm (95% confidence interval (CI) 0.7, 5.5)) and had decreased waist-to-height ratio (exposed-unexposed mean difference - 0.03 (95% CI - 0.058, - 0.002)). Males exposed to ANCS had lower total cholesterol (exposed-unexposed mean difference - 0.54 mmol/l (95%CI - 0.83, - 0.06)). Conclusion: Among adolescents born with VLBW, ANCS exposure was not associated with markers of increased cardiometabolic risk.