Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children

Antenatal corticosteroid therapy substantially improves the survival rate o f preterm infants, with few side effects. Higher blood pressure in adulthoo d has been described in several animal species after exposure to antenatal corticosteroids, but there are no similar reports in humans. The objective of the present study was to determine the relationship between exposure to antenatal corticosteroid therapy and blood pressure at 14 years of age. Thi s was a cohort study of 210 preterm survivors with birthweights of < 1501 g born in the Royal Women's Hospital, Melbourne, between January 1977 and 31 March 1982. Blood pressure was measured in 177 subjects (84.3%) at 14 year s of age with a standard mercury sphygmomanometer. Children exposed to ante natal corticosteroids (n = 89) had higher systolic and diastolic blood pres sures than those not exposed to corticosteroids (n = 88) [mean difference ( 95% confidence interval) (mmHg):systolic, 4.1 (0.1-8.0); diastolic, 2.8 (0. 05-5.6)]. However, few had blood pressure in the hypertensive range. It is concluded that antenatal corticosteroid therapy is associated with higher s ystolic and diastolic blood pressures in adolescence, and might lead to cli nical hypertension in survivors well beyond birth.