Cargando…

Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study

OBJECTIVES: To identify whether children with antenatal prednisone exposure have chronically elevated cortisol and cortisone concentrations, an altered body composition or higher blood pressure. In addition, to identify whether maternal rheumatoid arthritis disease (RA) activity is associated with t...

Descripción completa

Detalles Bibliográficos
Autores principales: Ince-Askan, Hilal, van den Akker, Erica L T, de Rijke, Yolanda B, van Rossum, Elisabeth F C, Hazes, Johanna M W, Dolhain, Radboud J E M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361363/
https://www.ncbi.nlm.nih.gov/pubmed/30815278
http://dx.doi.org/10.1136/rmdopen-2018-000852
_version_ 1783392675351756800
author Ince-Askan, Hilal
van den Akker, Erica L T
de Rijke, Yolanda B
van Rossum, Elisabeth F C
Hazes, Johanna M W
Dolhain, Radboud J E M
author_facet Ince-Askan, Hilal
van den Akker, Erica L T
de Rijke, Yolanda B
van Rossum, Elisabeth F C
Hazes, Johanna M W
Dolhain, Radboud J E M
author_sort Ince-Askan, Hilal
collection PubMed
description OBJECTIVES: To identify whether children with antenatal prednisone exposure have chronically elevated cortisol and cortisone concentrations, an altered body composition or higher blood pressure. In addition, to identify whether maternal rheumatoid arthritis disease (RA) activity is associated with these alterations. METHODS: In this prospective study, 56 children (mean age=10.0 years) with and 61 children (mean age=9.6 years) without antenatal prednisone exposure, born to women with RA, were included. Hair cortisol and cortisone were analysed using liquid chromatography–tandem mass spectrometry. Linear regression models were built to analyse differences between the two groups, corrected for relevant covariates. Hair cortisol concentrations were also compared between the study population and an age-matched healthy reference group(n=150 children, mean age=9.8 years). RESULTS: Hair cortisol and cortisone concentrations were similar in children with and without antenatal prednisone exposure (median cortisol 1.14 pg/mg (IQR 0.67–1.75) and 1.15 pg/mg (IQR 0.65–2.21) and median cortisone 6.76 pg/mg (IQR 5.42–8.86) and 7.40 pg/mg (IQR 5.39–10.73), respectively). Antenatal prednisone exposure and maternal RA disease activity were also not associated with body composition or blood pressure. Hair cortisol concentrations were not different in children born to mothers with RA compared with children from the reference group. CONCLUSION: This, in its kind, large and unique long-term prospective study demonstrates that low-dose antenatal prednisone exposure and maternal RA disease activity are not associated with negative consequences in prepubertal childhood. The findings of this study are reassuring and support the assumption that low-dose maternal prednisone use during pregnancy is safe for the offspring, at least until the age of approximately 10 years.
format Online
Article
Text
id pubmed-6361363
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-63613632019-02-27 Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study Ince-Askan, Hilal van den Akker, Erica L T de Rijke, Yolanda B van Rossum, Elisabeth F C Hazes, Johanna M W Dolhain, Radboud J E M RMD Open Rheumatoid Arthritis OBJECTIVES: To identify whether children with antenatal prednisone exposure have chronically elevated cortisol and cortisone concentrations, an altered body composition or higher blood pressure. In addition, to identify whether maternal rheumatoid arthritis disease (RA) activity is associated with these alterations. METHODS: In this prospective study, 56 children (mean age=10.0 years) with and 61 children (mean age=9.6 years) without antenatal prednisone exposure, born to women with RA, were included. Hair cortisol and cortisone were analysed using liquid chromatography–tandem mass spectrometry. Linear regression models were built to analyse differences between the two groups, corrected for relevant covariates. Hair cortisol concentrations were also compared between the study population and an age-matched healthy reference group(n=150 children, mean age=9.8 years). RESULTS: Hair cortisol and cortisone concentrations were similar in children with and without antenatal prednisone exposure (median cortisol 1.14 pg/mg (IQR 0.67–1.75) and 1.15 pg/mg (IQR 0.65–2.21) and median cortisone 6.76 pg/mg (IQR 5.42–8.86) and 7.40 pg/mg (IQR 5.39–10.73), respectively). Antenatal prednisone exposure and maternal RA disease activity were also not associated with body composition or blood pressure. Hair cortisol concentrations were not different in children born to mothers with RA compared with children from the reference group. CONCLUSION: This, in its kind, large and unique long-term prospective study demonstrates that low-dose antenatal prednisone exposure and maternal RA disease activity are not associated with negative consequences in prepubertal childhood. The findings of this study are reassuring and support the assumption that low-dose maternal prednisone use during pregnancy is safe for the offspring, at least until the age of approximately 10 years. BMJ Publishing Group 2019-01-30 /pmc/articles/PMC6361363/ /pubmed/30815278 http://dx.doi.org/10.1136/rmdopen-2018-000852 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Rheumatoid Arthritis
Ince-Askan, Hilal
van den Akker, Erica L T
de Rijke, Yolanda B
van Rossum, Elisabeth F C
Hazes, Johanna M W
Dolhain, Radboud J E M
Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
title Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
title_full Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
title_fullStr Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
title_full_unstemmed Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
title_short Associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
title_sort associations between antenatal prednisone exposure and long-term cortisol and cortisone concentrations in children born to women with rheumatoid arthritis: results from a nationwide prospective cohort study
topic Rheumatoid Arthritis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361363/
https://www.ncbi.nlm.nih.gov/pubmed/30815278
http://dx.doi.org/10.1136/rmdopen-2018-000852
work_keys_str_mv AT inceaskanhilal associationsbetweenantenatalprednisoneexposureandlongtermcortisolandcortisoneconcentrationsinchildrenborntowomenwithrheumatoidarthritisresultsfromanationwideprospectivecohortstudy
AT vandenakkerericalt associationsbetweenantenatalprednisoneexposureandlongtermcortisolandcortisoneconcentrationsinchildrenborntowomenwithrheumatoidarthritisresultsfromanationwideprospectivecohortstudy
AT derijkeyolandab associationsbetweenantenatalprednisoneexposureandlongtermcortisolandcortisoneconcentrationsinchildrenborntowomenwithrheumatoidarthritisresultsfromanationwideprospectivecohortstudy
AT vanrossumelisabethfc associationsbetweenantenatalprednisoneexposureandlongtermcortisolandcortisoneconcentrationsinchildrenborntowomenwithrheumatoidarthritisresultsfromanationwideprospectivecohortstudy
AT hazesjohannamw associationsbetweenantenatalprednisoneexposureandlongtermcortisolandcortisoneconcentrationsinchildrenborntowomenwithrheumatoidarthritisresultsfromanationwideprospectivecohortstudy
AT dolhainradboudjem associationsbetweenantenatalprednisoneexposureandlongtermcortisolandcortisoneconcentrationsinchildrenborntowomenwithrheumatoidarthritisresultsfromanationwideprospectivecohortstudy