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Paediatric and Perinatal Epidemiology

Does in utero exposure to synthetic glucocorticoids influence birthweight, head circumference and birth length? A systematic review of current evidence in humans

Authors

  • Anokhi Ali Khan,

    1. Department of Epidemiology and Biostatistics, Imperial College London Faculty of Medicine
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  • Alina Rodriguez,

    1. Department of Epidemiology and Biostatistics, Imperial College London Faculty of Medicine
    2. MRC Social Genetic Developmental Psychiatry (SGDP), King's College, London, UK
    3. Department of Psychology, Uppsala University, Uppsala, Sweden
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    • The authors contributed equally to this work.

  • Marika Kaakinen,

    1. Biocenter Oulu
    2. Institute of Health Sciences
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  • Anneli Pouta,

    1. National Institute for Health and Welfare
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  • Anna-Liisa Hartikainen,

    1. Institute of Clinical Medicine, University of Oulu, Oulu, Finland
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  • Marjo-Ritta Jarvelin

    Corresponding author
    1. Department of Epidemiology and Biostatistics, Imperial College London Faculty of Medicine
    2. Biocenter Oulu
    3. Institute of Health Sciences
      Marjo-Riitta Jarvelin, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
      E-mail: m.jarvelin@imperial.ac.uk
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    • The authors contributed equally to this work.


Marjo-Riitta Jarvelin, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.
E-mail: m.jarvelin@imperial.ac.uk

Summary

Ali Khan A, Rodriguez A, Kaakinen M, Pouta A, Hartikainen A-L, Jarvelin M-R. Does in utero exposure to synthetic glucocorticoids influence birthweight, head circumference and birth length? A systematic review of current evidence in humans. Paediatric and Perinatal Epidemiology 2010.

Synthetic glucocorticoids are the mainstay treatment for stimulating lung maturation in threatened preterm delivery. Animal studies suggest that in utero exposure to glucocorticoids leads to a reduction in birth size. Smaller birthweight has been associated with higher risk of many chronic diseases. Therefore, the authors undertook a systematic review of human studies examining the association between synthetic glucocorticoid treatment and birth size. Medline, EMBASE, PubMed, Cochrane, Google scholar and Institute of Life Science databases were searched for studies published between 1978 and 2009 investigating the association between synthetic glucocorticoids and birthweight, head circumference, birth length and ponderal index. All studies controlling for gestational age were examined. Seventeen studies were included in the analysis. Nine out of 17 studies reported a reduction in birthweight (range 12–332 g), five of nine a reduction of head circumference (range 0.31–1.02 cm) and two of four a reduction of 0.8 cm in birth length. Despite methodological inconsistencies and limitations that impede clear conclusions, the evidence suggests an association between in utero exposure to synthetic glucocorticoids and reduced birth size.

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