Background: In most countries of the world the prenatal glucocorticoid treatment to prevent reproductive losses in hyperandrogenic pregnancies has been found non-efficient. In Russia, up to present, dexamethasone has been listed in the standard threapy of pregnancy noncarrying risk of hyperandrogenic women. Simultaneuously, during the last decade the safety of treating pregnant women with synthetic glucocorticoids has been the subject-matter of intense debates considering possible adverse effects on the foetus and child health in the future.
Objective and hypotheses: To study possible long-term effects of prenatal glucocorticoid treatment on children cognition.
Method: From 2002 to 2011 the children of the DEX-exposed group (n=288) were examined at the age of early childhood (mean 2.7 years) and up to the primary school age (mean 7.8 years) (n=90). 57 infants of early childhood and 50 children of primary school age were included into the controls.
Results: The direct correlation has been established between quotients of intellectual development of primary school-aged children and the initiation date of prenatal dexamethasone treatment. The level of general intelligence of children whose mothers have been treated with dexamethasone in I and II trimesters of pregnancy is considerably lower than the controls. However, negative effects on speech development, verbal reasoning and logical thinking, maturity of volitional attention and ability of organizing and monitoring activities have been found. It is of special interest that examining children of the similar groups at an earlier age has not revealed any differences of their intellectual development. No differences of cognitive development between children, prenatally treated with dexamethasone in III trimester, and the controls have been observed.
Conclusion: Prenatal DEX-exposure at an early gestation can result in significant negative effects on intellectual abilities of children in the future; the earlier the gestation period of prenatal DEX-exposure, the more well-marked the depression of children cognition.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology