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Association of antenatal corticosteroids with kidney function in adolescents born preterm with very low birth weight

Journal of Perinatology volume 43, pages 1038–1044 (2023)Cite this article

Subjects

Abstract

Objective

Investigate if antenatal corticosteroids (ANCS) are associated with worse kidney function in adolescence and if greater adiposity magnifies this association.

Study design

Prospective cohort of 162 14-year-olds born preterm with very low birth weight (<1500 g). Outcomes were estimated glomerular filtration rate (eGFR) and first-morning urine albumin-to-creatinine ratio (UACR). We used adjusted generalized linear models, stratified by waist-to-height ratio (WHR) ≥ 0.5.

Results

Fifty-five percent had ANCS exposure and 31.3% had WHR ≥ 0.5. In adjusted analyses of the entire cohort, ANCS was not significantly associated with eGFR or UACR. However, the ANCS-eGFR association was greater in those with WHR ≥ 0.5 (β −16.8 ml/min/1.73 m2, 95% CL −31.5 to −2.1) vs. WHR < 0.5: (β 13.9 ml/min/1.73 m2, 95% CL −0.4 to 28.1), interaction term p = 0.02.

Conclusion

ANCS exposure was not associated with worse kidney function in adolescence, though ANCS may be associated with lower eGFR if children develop obesity by adolescence.

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Fig. 1: Consort flow diagram.
Fig. 2: Differences in estimated glomerular filtration rate according to antenatal corticosteroid exposure stratified by adiposity.

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Data availability

The datasets generated from this study are available from the corresponding author upon reasonable request.

Code availability

The code used to analyze the data from this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank the participants and their families, Alice Scott, RN, research study coordinator, and Patricia Brown, RN, research nurse, both of whom have no conflicts of interest.

Funding

Funding

This study was funded by the National Institutes of Health: National Institute of Diabetes and Digestive and Kidney Diseases T35DK007400, Eunice Kennedy Shriver National Institute of Child Health and Human Development P01HD047584 and P01HD084227, National Center for Research Resources M01RR07122 to the Clinical Research Unit of Wake Forest Baptist Medical Center, and National Center for Advancing Translational Sciences UL1TR001420 to the Wake Forest Clinical and Translational Science Award; the American Heart Association (14GRNT20480131 and 18TPA34170522), and the Forsyth Medical Center and Wake Forest University School of Medicine Department of Pediatrics research funds. AMS additionally reports funding from the National Institutes of Health National Heart, Lung, and Blood Institute K23HL148394, L40HL148910, R01HL146818, and R56HL164434.

Author information

Authors and Affiliations

  1. Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA

    Whitney N. Floyd

  2. Department of Statistical Sciences, Wake Forest University, Winston-Salem, NC, 27101, USA

    Daniel P. Beavers

  3. Division of Public Health Sciences, Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA

    Elizabeth T. Jensen & Andrew M. South

  4. Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, 27101, USA

    Lisa K. Washburn

  5. Department of Pediatrics, Section of Nephrology, Brenner Children’s, Wake Forest University School of Medicine, Winston Salem, NC, USA

    Andrew M. South

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Contributions

WNF conceptualized the research question, visualized the data and assisted with data interpretation, drafted the initial manuscript, and revised the manuscript. DPB assisted in the design of the analytic plan, analyzed the data, assisted with interpreting the data, and revised the manuscript. ETJ assisted in the study design, analytic plan, and interpretation of the results and revised the manuscript. LKW conceptualized and designed the study, supervised data collection, and revised the manuscript. AMS assisted with developing the research question, conceptualized and designed the analytic plan, assisted with analyzing and interpreting the data, created the figures, at all times had full access to and takes full responsibility for the data, and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable fully for all aspects of the work.

Corresponding author

Correspondence to Andrew M. South.

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Floyd, W.N., Beavers, D.P., Jensen, E.T. et al. Association of antenatal corticosteroids with kidney function in adolescents born preterm with very low birth weight. J Perinatol 43, 1038–1044 (2023). https://doi.org/10.1038/s41372-023-01688-3

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