Association of Antenatal Corticosteroids with Future Kidney Function in Adolescents Born Preterm with Very Low Birth Weight

Background: Antenatal corticosteroids (ANCS) are administered to pregnant women at risk of preterm delivery to accelerate fetal lung development. Animal studies suggest that ANCS lead to deleterious alterations to several cardiovascular and renal pathways in the offspring, though the persistent effects of ANCS exposure on long-term health remain undescribed.

Hypothesis: We hypothesized that ANCS are associated with unfavorable alterations to kidney function in adolescents born preterm.

Methods: In a prospective birth cohort of 14-year-old adolescents born preterm (<37 weeks’ gestation) with very low birth weight (VLBW, <1500 g), we measured serum creatinine and first-morning urine samples for urine albumin standardized to urine creatinine in 95 participants. We estimated glomerular filtration rate (eGFR). We used generalized linear models to estimate the association of ANCS with the outcomes.

Results: The cohort consisted of 58% non-Black participants and 55% female participants; 53% were exposed to ANCS and 7% had albuminuria. In unadjusted analyses, ANCS was not associated with eGFR (β 3.2 ml/min/1.73 m², 95% CI -5.8 to 12.1), ACR (β -3.21 mg/g, 95% CI -13.93 to 7.52), or albuminuria (OR 0.78, 95% CI 0.24 to 2.48).

Conclusions: ANCS exposure was not associated with adverse kidney outcomes in adolescents born preterm with VLBW. Future analyses will include adjusting for potentially confounding factors in multivariable models, analyzing obesity as an effect modifier, and continuing to assess participants’ long-term kidney function.