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The Effect of Antenatal Corticosteroid Use on Offspring Cardiovascular Function: A Systematic Review
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  • Adalina Sacco,
  • Emily Cornish (CPD ASSOCIATE),
  • Neil Marlow,
  • Anna David,
  • Dino Giussani
Adalina Sacco
University College London Hospitals NHS Foundation Trust

Corresponding Author:[email protected]

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Emily Cornish (CPD ASSOCIATE)
UCL Institute for Women's Health
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Neil Marlow
University College London Institute for Women's Health
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Anna David
University College London Hospitals NHS Foundation Trust
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Dino Giussani
University of Cambridge
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Abstract

Background Antenatal corticosteroids (ACS) are recommended in threatened preterm labour to improve short term neonatal outcome. Preclinical animal studies suggest detrimental effects of ACS exposure on offspring cardiac development; their effects in humans are unknown. Objectives To systematically review the human clinical literature to determine the effects of ACS on offspring cardiovascular function. Main results Twenty-six studies including 1921 patients were included, of which most were cohort studies of mixed quality. The type of ACS exposure, gestational age at exposure, dose and number of administrations varied widely. Offspring cardiovascular outcomes were assessed from one day to 36 years postnatally. The most commonly assessed parameter was arterial blood pressure (18 studies), followed by echocardiography (8 studies), heart rate (5 studies), electrocardiogram (ECG, 3 studies) and cardiac magnetic resonance imaging (MRI, 1 study). There were no clinically significant effects of ACS exposure on offspring blood pressure. However, there were insufficient studies assessing cardiac structure and function using echocardiography or cardiac MRI to be able to determine an effect. Conclusions Administration of ACS is not associated with long-term effects on blood pressure in exposed human offspring. The effects on cardiac structure and other measures of cardiac function were unclear due to the small number of studies, study heterogeneity and mixed quality. Given the emerging preclinical evidence of harm following ACS exposure, there is a need for further research to assess central cardiac function in human offspring exposed to ACS. Keywords: Antenatal corticosteroids, ACS, cardiovascular, offspring, blood pressure
10 May 2022Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
12 May 2022Submission Checks Completed
12 May 2022Assigned to Editor
22 May 2022Reviewer(s) Assigned
22 Jun 2022Review(s) Completed, Editorial Evaluation Pending
11 Jul 2022Editorial Decision: Revise Minor
21 Aug 20221st Revision Received
22 Aug 2022Submission Checks Completed
22 Aug 2022Assigned to Editor
22 Aug 2022Review(s) Completed, Editorial Evaluation Pending
25 Aug 2022Editorial Decision: Accept
27 Oct 2022Published in BJOG: An International Journal of Obstetrics & Gynaecology. 10.1111/1471-0528.17316