Kidney Week

Abstract: PO1957

Association of Antenatal Corticosteroids with Later Kidney Function in Adolescents Born Preterm with Very Low Birth Weight

Session Information

• Pediatric Nephrology: AKI, Dialysis, Transplant, CKD, and Nephrotic Syndrome
  November 04, 2021 | Location: On-Demand, Virtual Only
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1700 Pediatric Nephrology

Authors

• Floyd, Whitney Nicole, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States

Whitney Nicole Floyd

• South, Andrew M., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States

Andrew M. South,

Background

Antenatal corticosteroids (ANCS) are given to pregnant women who are at risk of preterm delivery to accelerate fetal lung development. While studies in sheep suggest that ANCS program deleterious effects on renal development leading to higher blood pressure (BP) and worse kidney function, the persistent effects of ANCS exposure on the long-term health of at-risk individuals remains undescribed. We investigated the association of ANCS with BP and kidney function in adolescents born preterm and hypothesized that ANCS are associated with worse BP and kidney function.

Methods

This was a long-term prospective birth cohort of 175 14-year-old adolescents born preterm with very low birth weight (VLBW, <1500 g). We measured manual BP, serum creatinine, and first-morning urine albumin-to-creatinine ratio (ACR), defined high BP as ≥120/80 mmHg and albuminuria as ACR >30 mg/g, and calculated the estimated glomerular filtration rate (eGFR). We used generalized linear models to estimate the association of ANCS with the outcomes.

Results

The cohort consisted of 58% non-Black participants, 55% female participants, and 53% were exposed to ANCS. Among all participants, mean systolic BP was 106.4 mmHg, 13% had high BP, median eGFR was 124.9 ml/min/1.73 m² (n=123), and 7% had albuminuria (n=134). In unadjusted analyses, ANCS was not associated with high BP (RR 1.08 mmHg, 95% CI 0.49–2.37), eGFR (β 3.74 ml/min/1.73 m², 95% CI -6.74 to 14.22), or albuminuria (RR 1.31, 95% CI 0.34–5.01).

Conclusion

Our research findings indicate that ANCS exposure was not associated with compromised kidney function or worse BP in adolescents born preterm with VLBW. Future analyses will include adjusting for potentially confounding factors in multivariable models and continuing to assess participants’ long-term BP and kidney function.