Gestational systemic glucocorticoids exposure carries risk of kidney disease in childhood

Children with gestational exposure to systemic glucocorticoids face an increased risk of having kidney disease, according to a retrospective cohort study.

The study included 23,363 singleton-born children in Taiwan. Maternal prescriptions for systemic glucocorticoids between the last menstrual period and birth was used as a proxy for gestational exposure.

Cox proportional hazards models with stabilized inverse probability of treatment weighting and robust sandwich estimator were used to estimate the association between gestational systemic glucocorticoid exposure and the incidence of childhood chronic kidney disease (CKD), including congenital anomalies of the kidney and urinary tract (CAKUT) and other kidney diseases (non-CAKUT), over 10 years.

Results showed that gestational systemic glucocorticoid exposure was associated with a 69-percent higher risk of childhood CKD (adjusted hazard ratio [aHR], 1.69, 95 percent confidence interval [CI], 1.01–2.84).

In stratified analyses, stronger associations were observed among children within the strata of birth <37 weeks gestational age (aHR, 2.38, 95 percent CI, 1.19–4.78), those assigned male at birth (aHR, 1.89, 95 percent CI, 1.00–3.55), those with gestational exposure in the second trimester (aHR, 6.70, 95 percent CI, 2.17–20.64), and those exposed to a total dose of >24 mg hydrocortisone equivalent (aHR, 1.91, 95 percent CI, 1.05–3.47).

The present data, if validated, may inform the prescribing of systemic glucocorticoids during pregnancy.