#2-19E. Long-Term Infection Risk After Antenatal Corticosteroids Exposure (JNO, 2025)

Antenatal corticosteroids (ACS) are standard care for imminent preterm birth, but how do these powerful agents affect long-term offspring health, extending well beyond the neonatal period? This large population-based cohort study, utilizing nationwide registry data from over 1.5 million mother-child pairs in Finland and Scotland, investigated the long-term association between maternal ACS exposure and the risk of respiratory and nonrespiratory infections from childhood up to age . The crucial finding reveals that ACS exposure was significantly associated with an increased risk of infections only in children born at or after 34 weeks' gestation, including late preterm and full-term infants (e.g., adjusted HR 1.31 for nonrespiratory infections in full-term infants). Conversely, children born before 34 weeks showed no association with increased long-term infection risk in the fully adjusted models, reinforcing the known short-term benefits in this vulnerable group67. However, a major limitation is the missing data regarding ACS dosage, specific indication, and administration timing, preventing the assessment of dose- or time-dependent effects8. These findings necessitate a critical re-evaluation of current ACS guidelines, particularly for late preterm and early term deliveries, urging clinicians to adopt more stringent criteria when weighing the essential short-term benefits against the potential long-term infectious morbidity risks.

Citation: Decrue F, et al. Antenatal Corticosteroids and Infectious Diseases Throughout Childhood. JAMA Network Open. 2025. DOI: 10.1001/jamanetworkopen.2025.36809

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