Lin Yi-Hsuan, Lin Ching-Heng, Lin Ming-Chih, Hsu Ya-Chi, Hsu Chung-Ting
Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan; Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan.
J Pediatr. 2023 Feb;253:245-251.e2. doi: 10.1016/j.jpeds.2022.09.050. Epub 2022 Oct 4.
To study the association between antenatal corticosteroids treatment and childhood mental disorders in infants born at different gestational ages, and to investigate the effect of different administration timing.
This population-based cohort study used data from the Taiwan National Health Insurance Research Database. All singleton live births born between 2004 and 2010 were enrolled and followed up for at least 6 years. The primary outcome was any childhood mental disorder. Secondary outcomes included 7 specific subgroups of mental disorders.
A total of 1 163 443 singleton infants were included in the analysis, and 16 847 (1.45%) infants were exposed to antenatal corticosteroid treatment. Children exposed to antenatal corticosteroids were found to have a higher risk of developing childhood mental disorders in the entire cohort (hazard ratio [HR], 1.13; 95% CI, 1.08-1.18), the term group (HR, 1.11; 95% CI, 1.05-1.16), and the late-preterm group (HR, 1.15; 95% CI, 1.06-1.25). The administration of corticosteroids in the early stage of pregnancy (<28 weeks of gestation) significantly increased the risk of childhood mental disorders (HR, 1.22; 95% CI, 1.14-1.31).
Exposure to antenatal corticosteroid treatment increases the cumulative risk of childhood mental disorders and attention deficit hyperactivity disorders, both in term and late preterm infants. The administration of corticosteroids in the early stage of pregnancy tends to increase the risk of mental disorders.
研究不同孕周出生婴儿的产前糖皮质激素治疗与儿童期精神障碍之间的关联，并探讨不同给药时机的影响。
这项基于人群的队列研究使用了台湾国民健康保险研究数据库的数据。纳入了2004年至2010年间所有单胎活产婴儿，并进行了至少6年的随访。主要结局是任何儿童期精神障碍。次要结局包括7个特定的精神障碍亚组。
总共1163443名单胎婴儿纳入分析，其中16847名（1.45%）婴儿接受了产前糖皮质激素治疗。在整个队列中，接受产前糖皮质激素治疗的儿童患儿童期精神障碍的风险更高（风险比[HR]，1.13；95%置信区间[CI]，1.08 - 1.18），足月儿组（HR，1.11；95%CI，1.05 - 1.16）和晚期早产儿组（HR，1.15；95%CI，1.06 - 1.25）。在妊娠早期（<28周）给予糖皮质激素显著增加了儿童期精神障碍的风险（HR，1.22；95%CI，1.14 - 1.31）。
产前糖皮质激素治疗的暴露增加了足月儿和晚期早产儿患儿童期精神障碍和注意力缺陷多动障碍的累积风险。在妊娠早期给予糖皮质激素往往会增加精神障碍的风险。
