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Int. J. Environ. Res. Public Health 2016, 13(12), 1206; doi:10.3390/ijerph13121206

Antenatal Dexamethasone Exposure in Preterm Infants Is Associated with Allergic Diseases and the Mental Development Index in Children

1
Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
2
Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
3
Department of Traditional Chinese Medicine, Chang Gung University, Taoyuan 33302, Taiwan
These authors contributed equally to this work.
*
Authors to whom correspondence should be addressed.
Academic Editors: Katherine P. Theall and Carolyn C. Johnson
Received: 6 October 2016 / Revised: 16 November 2016 / Accepted: 1 December 2016 / Published: 3 December 2016
(This article belongs to the Special Issue Environmental Influences on Maternal and Child Health)
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Abstract

Background: Antenatal steroid administration may benefit fetal lung maturity in preterm infants. Although some studies have shown that this treatment may increase asthma in childhood, the correlation between antenatal dexamethasone exposure and allergic diseases remains unclear. The purpose of this study is to investigate the association between antenatal dexamethasone and T cell expression in childhood allergic diseases. Methods: We recruited a cohort of preterm infants born at Kaohsiung Chang Gung Memorial Hospital between 2007 and 2010 with a gestational age of less than 35 weeks and body weight at birth of less than 1500 g. The status of antenatal exposure to steroids and allergic diseases were surveyed using a modified ISAAC questionnaire for subjects aged 2–5 years old. We analyzed Th1/Th2/Th17 expression of mRNA, cytokines (using the Magpix® my-system), and mental development index (MDI). Results: Among the 40 patients that were followed, the data showed that the antenatal dexamethasone exposure group (N = 24) had a significantly higher incidence of allergic diseases (75.0% vs. 18.8%, p < 0.0001) when compared to the non-dexamethasone exposure group (N = 16), especially with regard to asthma (41.7% vs. 0.0%, p = 0.003) and allergic rhinitis (58.3% vs. 18.8%, p = 0.013), but not atopic dermatitis. No statistical difference was observed in the mRNA expression levels of total white blood cell count between the dexamethasone exposure and non-exposure groups (p > 0.05). However, the asthma group had higher IL-5 levels (p = 0.009), and the MDI was shown to be significantly higher in the dexamethasone exposure group (90.38 ± 3.31 vs. 79.94 ± 3.58, p = 0.043) while no significant difference was found between the PDI of the two groups. Conclusions: Exposure to antenatal dexamethasone in preterm infants will increase their susceptibility to allergic diseases, particularly asthma and allergic rhinitis. Preterm infants’ exposure to antenatal dexamethasone also results in higher MDI scores. Such increases in allergic diseases may be related to increased IL-5 and IL-10 levels. View Full-Text
Keywords: prenatal; dexamethasone; mental development index (MDI); psychomotor developmental index (PDI); allergy prenatal; dexamethasone; mental development index (MDI); psychomotor developmental index (PDI); allergy
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MDPI and ACS Style

Tseng, W.-N.; Chen, C.-C.; Yu, H.-R.; Huang, L.-T.; Kuo, H.-C. Antenatal Dexamethasone Exposure in Preterm Infants Is Associated with Allergic Diseases and the Mental Development Index in Children. Int. J. Environ. Res. Public Health 2016, 13, 1206.

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