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Repeated Course Antenatal Steroids, Inflammation Gene Polymorphisms and Neurodevelopmental Outcomes at Age 2

Citation

Clark, Erin A. S.; Mele, Lisa; Wapner, Ronald J.; Spong, Catherine Y.; Sorokin, Yoram; Peaceman, Alan M.; Iams, Jay D.; Leveno, Kenneth J.; Harper, Margaret A.; & Caritis, Steve N., et al. (2011). Repeated Course Antenatal Steroids, Inflammation Gene Polymorphisms and Neurodevelopmental Outcomes at Age 2. American Journal of Obstetrics & Gynecology, 205(1), 79.e1-5. PMCID: PMC3743532

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.

URL

http://dx.doi.org/10.1016/j.ajog.2011.02.061

Reference Type

Journal Article

Year Published

2011

Journal Title

American Journal of Obstetrics & Gynecology

Author(s)

Clark, Erin A. S.
Mele, Lisa
Wapner, Ronald J.
Spong, Catherine Y.
Sorokin, Yoram
Peaceman, Alan M.
Iams, Jay D.
Leveno, Kenneth J.
Harper, Margaret A.
Caritis, Steve N.
Mercer, Brian M.
Thorp, John M., Jr.
Ramin, Susan M.
Carpenter, Marshall W.
Rouse, Dwight J., for the
Eunice Kennedy Shriver
National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network

PMCID

PMC3743532