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Pregnancy complications, not synthetic glucocorticoid exposure, linked to low IQ in offspring
In children whose mothers received antenatal synthetic glucocorticoids for prevention of preterm delivery, long-term decreases in intelligence may be linked to the pregnancy complications driving preterm delivery risk, rather than synthetic glucocorticoid treatment itself.
Researchers recruited 222 term-born children aged 6 to 11 years from three groups: children of mothers admitted to the hospital for the threat of preterm delivery who were treated with synthetic glucocorticoids (n = 97), those not treated (n = 36) and controls without pregnancy complications (n = 89). The study’s main outcome measure was cognitive function assessed by an adapted German version of the Cattell culture-fair test.
Researchers found that, overall, the children’s IQ scores ranged from 78 to 159 and were not associated with sex, maternal age at delivery, gestational age, delivery method, Apgar scores or cord blood pH values.
Children of women with pathophysiological pregnancy who underwent treatment with synthetic glucocorticoids had lower IQ scores compared with controls (P = .002); the decrease in IQ scores was similar in children of mothers with pathological pregnancy who were not treated with synthetic glucocorticoids (P = .018).
In a post-hoc analysis, no difference was found between children whose mothers had complications whether they were treated or not. Researchers found that regardless of antenatal synthetic glucocorticoid exposure, children born to mothers hospitalized with pathological pregnancies and threatening preterm delivery scored on average 6 to 7 IQ points lower than those whose mothers had no pregnancy complication. Compared with female children, boys were more vulnerable to the negative IQ effects associated with maternal risk of preterm delivery. A subsample stratified by education level of parents revealed results that were highly similar to those seen in the overall sample.
"We report that conditions related to a threatening preterm delivery rather than antenatal [synthetic glucocorticoid] exposure per se are associated with a substantial decrease in the children’ general cognitive functioning,” the researchers wrote. “This distinction is important, as it is suggestive of very different clinical implications. While our findings imply that a single course of [synthetic glucocorticoid like dexamethasone] or [betamethasone] does not aggravate long-term cognitive deficits in [pathological pregnancy] children, they highlight the need for interventions to reduce adverse effects of a threatening preterm delivery.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.