Repeated course antenatal steroids, inflammation gene polymorphisms, and neurodevelopmental outcomes at age 2 - 19/08/11
, Lisa Mele, ScM n, Ronald J. Wapner, MD b, Catherine Y. Spong, MD o, Yoram Sorokin, MD c, Alan Peaceman, MD d, Jay D. Iams, MD e, Kenneth J. Leveno, MD f, Margaret Harper, MD g, Steve N. Caritis, MD h, Brian M. Mercer, MD i, John M. Thorp, MD j, Susan M. Ramin, MD k, Marshall Carpenter, MD l, Dwight J. Rouse, MD mEunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
Reprints: Erin A. S. Clark, MD, University of Utah School of Medicine, Suite 2B200, 30 N. 1900 E, Salt Lake City, UT 84132Résumé |
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.
Le texte complet de cet article est disponible en PDF.Key words : antenatal corticosteroids, gene polymorphisms, inflammation, interleukin-6, neurodevelopmental delay
Plan
| Other members of the Eunice Kennedy Shriver National Institute of Child Health and Human Development MFMU Network are listed in the Appendix. |
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| Supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD21410, HD27869, HD27917, HD27860, HD27915, HD34116, HD34208, HD34136, HD40500, HD40485, HD40544, HD40545, HD40560, HD40512, HD36801) and M01-RR-000080 from the National Center for Research Resources. |
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| Cite this article as: Clark EAS, Mele L, Wapner RJ, et al. Repeated course antenatal steroids, inflammation gene polymorphisms, and neurodevelopmental outcomes at age 2. Am J Obstet Gynecol 2011;205:79.e1-5. |
Vol 205 - N° 1
P. 79.e1-79.e5 - juillet 2011 Retour au numéro
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