Antenatal Corticosteroids and Cardio-metabolic Outcomes in Adolescents Born With Very Low Birth Weight

BACKGROUND: Exposure to antenatal corticosteroids (ANCS) is associated with adverse cardio-metabolic 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 cardio-metabolic risk in adolescents born with very low birth weight (VLBW). METHODS: In an observational cohort of 186 VLBW 14-year-old adolescents 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 to adolescents unexposed to ANCS, those exposed to ANCS were taller [exposed-unexposed mean difference 3.1 cm (95% 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 cardio-metabolic risk.