University of Oulu

Wolford, E., Lahti-Pulkkinen, M., Girchenko, P., Lipsanen, J., Tuovinen, S., Lahti, J., Heinonen, K., Hämäläinen, E., Kajantie, E., Pesonen, A., Villa, P., Laivuori, H., Reynolds, R., Räikkönen, K. (2019) Associations of antenatal glucocorticoid exposure with mental health in children. Psychological Medicine, 50 (2), 247-257.

Associations of antenatal glucocorticoid exposure with mental health in children

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Author: Wolford, Elina1; Lahti-Pulkkinen, Marius1,2; Girchenko, Polina1;
Organizations: 1Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
2University/British Heart Foundation Centre for Cardiovascular Science, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
3Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
4Folkhälsan Research Centre, Helsinki, Finland
5Department of Clinical Chemistry, University of Helsinki, Helsinki, Finland
6National Institute for Health and Welfare, Helsinki, Finland
7Children’s Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
8PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
9Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
10Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
11Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
12Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
13Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: Cambridge University Press, 2020
Publish Date: 2020-09-23


Background: Synthetic glucocorticoids, to enhance fetal maturation, are a standard treatment when preterm birth before 34 gestational weeks is imminent. While morbidity- and mortality-related benefits may outweigh potential neurodevelopmental harms in children born preterm (<37 gestational weeks), this may not hold true when pregnancy continues to term (⩾37 gestational weeks). We studied the association of antenatal betamethasone exposure on child mental health in preterm and term children.

Methods: We included 4708 women and their children, born 2006–2010, from the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction Study with information on both antenatal betamethasone treatment and child mental and behavioral disorders from the Finnish Hospital Discharge Register from the child’s birth to 31 December 2016. Additional follow-up data on mother-reported psychiatric problems and developmental milestones were available for 2640 children at 3.5 (s.d. = 0.07) years-of-age.

Results: Of the children, 187 were born preterm (61 betamethasone-exposed) and 4521 at term (56 betamethasone-exposed). The prevalence of any mental and behavioral, psychological development, emotional and behavioral, and comorbid disorders was higher in the betamethasone-exposed, compared to non-exposed children [odds ratio 2.76 (95% confidence interval 1.76–4.32), 3.61 (2.19–5.95), 3.29 (1.86–5.82), and 6.04 (3.25–11.27), respectively]. Levels of psychiatric problems and prevalence of failure to meet the age-appropriate development in personal-social skills were also higher in mother-reports of betamethasone-exposed children. These associations did not vary significantly between preterm and term children.

Conclusions: Antenatal betamethasone exposure may be associated with mental health problems in children born preterm and in those who end up being born at term.

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Series: Psychological medicine
ISSN: 0033-2917
ISSN-E: 1469-8978
ISSN-L: 0033-2917
Volume: 50
Issue: 2
Pages: 247 - 257
DOI: 10.1017/S0033291718004129
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: The PREDO study is funded by the Academy of Finland; European Commission (Horizon 2020 Award SC1-2016-RTD-733280 RECAP); European Commission Dynamics of Inequality Across the Life-course: structures and processes(DIAL) No 724363 for PremLife; EraNet Neuron; EVO (a special state subsidy for health science research); University of Helsinki Research Funds; the Signe and Ane Gyllenberg Foundation; the Emil Aaltonen Foundation; the Finnish Medical Foundation; the Jane and Aatos Erkko Foundation; the Novo Nordisk Foundation; the Päivikki and Sakari Sohlberg Foundation; the Sigrid Juselius Foundation; and the Sir Jules Thorn Charitable Trust.
Copyright information: This article has been published in a revised form in Psychological Medicine This version is published under a Creative Commons CC-BY-NC-ND. No commercial re-distribution or re-use allowed. Derivative works cannot be distributed. © Cambridge University Press 2019.