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Cognitive outcome in adolescents and young adults after repeat courses of antenatal corticosteroids
Stockholm University, Faculty of Social Sciences, Department of Psychology.
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2013 (English)In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 163, no 2, 441-446 p.Article in journal (Refereed) Published
Abstract [en]

Objective To investigate whether repeat courses of antenatal corticosteroids have long-term effects on cognitive and psychological functioning. Study design In a prospective cohort study, 58 adolescents and young adults (36 males) who had been exposed to 2-9 weekly courses of betamethasone in utero were assessed with neuropsychological tests and behavior self-reports. Unexposed subjects (n = 44, 25 males) matched for age, sex, and gestational age at birth served as a comparison group. In addition, individuals exposed in utero to a single course (n = 25, 14 males) were included for dose-response analysis. Group differences were investigated using multilevel linear modeling. Results Mean scores obtained in 2 measures of attention and speed were significantly lower in subjects exposed to 2 or more antenatal corticosteroids courses (Symbol Search, P = .009; Digit Span Forward, P = .02), but these were not dose-dependent. Exposure to repeat courses of antenatal corticosteroids was not associated with general deficits in higher cognitive functions, self-reported attention, adaptability, or overall psychological function. Conclusions Although this study indicates that repeat exposure to antenatal corticosteroids may have an impact on aspects of executive functioning, it does not provide support for the prevailing concern that such fetal exposure will have a major adverse impact on cognitive functions and psychological health later in life.

Place, publisher, year, edition, pages
2013. Vol. 163, no 2, 441-446 p.
Keyword [en]
WAIS, Wechsler Adult Intelligence Scale, WISC, Wechsler Intelligence Scale for Children
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-94190DOI: 10.1016/j.jpeds.2013.01.030ISI: 000322959500029OAI: oai:DiVA.org:su-94190DiVA: diva2:652483
Note

AuthorCount:6;

Available from: 2013-09-30 Created: 2013-09-30 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Rough beginnings: Executive function in adolescents and young adults after preterm birth and repeat antenatal corticosteroid treatment
Open this publication in new window or tab >>Rough beginnings: Executive function in adolescents and young adults after preterm birth and repeat antenatal corticosteroid treatment
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis investigates long-term cognitive outcome in two cohorts of adolescents and young adults exposed to stressors during the perinatal period: one group born preterm (<37 weeks of gestation and birth weight <1,500 g); one group exposed to two or more courses of antenatal corticosteroids (ACS), to stimulate lung maturation in the face of threatening preterm birth. In fetal life the brain undergoes dramatic growth, and a disruption to the early establishment of functional neural networks may interrupt development in ways that are difficult to predict. Executive function refers to a set of cognitive processes that are important for purposeful regulation of thought, emotion, and behavior, and even a subtle depreciation may influence overall functioning. Study I investigated the stability of executive function development after preterm birth. Executive functions were differentiated into working memory and cognitive flexibility. Both components were highly stable from preschool age to late adolescence. In Study II, we identified subgroups within the group of children born preterm with respect to cognitive profiles at 5½ and 18 years, and identified longitudinal streams. Outcome after preterm birth was diverse, and insufficiently predicted by perinatal and family factors. Individuals performing at low levels at 5½ years were unlikely to improve over time, while a group of individuals performing at or above norm at 5½ years had improved their performance relative to term-born peers by age 18. Studies I and II pointed to the need for developmental monitoring of those at risk, prior to formal schooling. Study III investigated long-term cognitive outcome after repeat ACS treatment. The study did not provide support for the concern that repeat ACS exposure will have an adverse impact on cognitive function later in life. In sum, exposure to perinatal stressors resulted in great variation in outcome. However, for many, their rough beginnings had not left a lasting mark.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2014. 100 p.
Keyword
cognitive flexibility, cluster analysis, development, latent variable analysis, longitudinal studies, parental education, perinatal medical complications, person-oriented approach, structural equation modeling, working memory
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-106798 (URN)978-91-7447-945-4 (ISBN)
Public defence
2014-10-15, David Magnussonsalen (U31), Frescati Hagväg 8, Stockholm, 10:00 (English)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 1: Submitted.

Available from: 2014-09-23 Created: 2014-08-20 Last updated: 2014-10-03Bibliographically approved

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