Repeated course antenatal steroids, inflammation gene polymorphisms, and neurodevelopmental outcomes at age 2

Am J Obstet Gynecol. 2011 Jul;205(1):79.e1-5. doi: 10.1016/j.ajog.2011.02.061. Epub 2011 Feb 27.

Abstract

Objective: We sought to evaluate the interaction between repeated-course antenatal corticosteroids and inflammation gene polymorphisms with neurodevelopmental outcomes at age 2 years.

Study design: We conducted nested case-control analysis of a randomized controlled trial of single- vs repeated-course antenatal corticosteroids. Cases had mental and/or psychomotor delay at age 2 years. Controls had normal neurodevelopment. Previous analyses of 125 cases and 147 controls identified 4 inflammation gene polymorphisms associated with neurodevelopmental delay at age 2 years.

Results: The interaction between repeated-course corticosteroids and the interleukin (IL)-6 -174 genotype with neurodevelopmental delay was significant (P = .046). The IL-6 -174 GG genotype was associated with neurodevelopmental delay at age 2 years in the single-course corticosteroid group (odds ratio, 6.47; 95% confidence interval, 1.86-22.50). Exposure to repeated-course antenatal corticosteroids abrogated this genotype effect (odds ratio, 1.30; 95% confidence interval, 0.48-3.54). Results were unchanged after controlling for potential confounders.

Conclusion: Repeated-course antenatal steroids may reduce the increased risk of neurodevelopmental delay at age 2 years associated with IL-6 -174 GG genotype.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adrenal Cortex Hormones / adverse effects*
  • Adrenal Cortex Hormones / therapeutic use
  • Case-Control Studies
  • Central Nervous System / drug effects*
  • Central Nervous System / growth & development*
  • Child Development / drug effects*
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Inflammation / genetics
  • Interleukin-6 / genetics*
  • Male
  • Polymorphism, Single Nucleotide*
  • Randomized Controlled Trials as Topic

Substances

  • Adrenal Cortex Hormones
  • Interleukin-6

Grants and funding