Children exposed to steroids between 34 to 36 weeks of pregnancy do not show an increased likelihood of cognitive effects compared to those whose mothers did not receive the treatment, according to a study funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). These findings ease concerns that prenatal steroid exposure—administered to accelerate lung development in cases of potential preterm birth—might impact a child's neurodevelopment.

The study, led by Cynthia Gyamfi-Bannerman, M.D., M.S., and her colleagues from the NICHD Maternal-Fetal Medicine Units Network, was published in the Journal of the American Medical Association.

Background
An earlier study found that administering a single dose of the steroid betamethasone to pregnant individuals at risk of delivering between 34 to 36 weeks significantly lowered the risk of respiratory issues in newborns. However, the same study noted that these infants had a higher incidence of hypoglycemia (low blood sugar), which, if prolonged, could lead to brain injury. Other research has raised concerns that multiple doses of prenatal steroids could impact a child's neurodevelopment.

Results
In this follow-up study, researchers assessed the children of participants from the previous study, now aged six or older. A psychologist conducted a series of tests to measure verbal and nonverbal reasoning and comprehension. A total of 949 children were tested—479 from the betamethasone group and 470 from the placebo group.

Both groups performed similarly across all sections of the Differential Ability Scales test. In the betamethasone group, 17.1% scored below 85, closely matching the 18.5% in the placebo group. The average score for both groups was 96.6, compared to a national average of 100. Scores were also comparable for verbal ability, nonverbal ability, spatial ability, social responsiveness, gross motor function, and behavior.

Significance
The authors conclude that administering steroids to pregnant individuals at risk for late preterm birth to reduce respiratory complications in their infants is not linked to negative neurodevelopmental outcomes at age 6 or older. These results support the continued use of corticosteroids for those at risk of late preterm birth.

Reference: https://www.nichd.nih.gov/newsroom/news/042524-preterm-steroids