{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:02:38Z","timestamp":1789783358998,"version":"4.0.1"},"reference-count":29,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>International guidelines recommend the use of antenatal corticosteroids (ACS) in pregnancies at risk of imminent preterm birth before 34 weeks\u2019 gestation. However, whether ACS leads to long-term risk of infection from childhood to adulthood is unknown.<\/jats:p><\/jats:sec>Objective<\/jats:title>To determine whether preterm (&amp;lt;37 weeks\u2019 gestation) and full-term (37-41 weeks\u2019 gestation) children exposed to ACS are more susceptible to respiratory and nonrespiratory infections compared with ACS-unexposed children throughout childhood and adolescence.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This population-based cohort study used data from the multicenter Consortium for the Study of Pregnancy Treatments (Co-OPT) study, including data from nationwide registries for mothers and their children in Finland and Scotland. Singleton children born from 1997 to 2018 and 2006 to 2018 in Scotland and Finland, respectively, were followed up until 2018, death, or first infection. Data were analyzed between June 2022 and October 2023.<\/jats:p><\/jats:sec>Exposures<\/jats:title>Maternal ACS treatment.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Primary and secondary outcomes were the first diagnosis of respiratory or nonrespiratory infection after birth-related hospital discharge. Outcomes were stratified by gestational age at birth.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 1\u202f548\u202f538 included mother-child pairs (mean [SD] maternal age, 29.4 [5.7] years; mean [SD] gestational age at birth, 39.2 [1.7] weeks; 759\u202f082 [49.0%] female neonates), 49\u202f263 children (3.2%) were ACS-exposed, of whom 34\u202f806 (70.7%) were preterm and 14\u202f457 (29.3%) were full term at birth. ACS-exposed children had more respiratory and nonrespiratory infections than nonexposed children (incidence rate, 65.2 vs 39.8 and 30.0 vs 17.9 per 1000 person-years, respectively). Compared with nonexposed children, higher risks for respiratory and nonrespiratory infections were found among ACS-exposed children born at 34 weeks 0 days to 36 weeks 6 days\u2019 gestation (adjusted hazard ratios [HRs], 1.10 [95% CI, 1.06-1.14] and 1.19 [95% CI, 1.15-1.24]), 37 0\/7 to 38 6\/7 weeks\u2019 gestation (adjusted HRs, 1.27 [95% CI, 1.21-1.32] and 1.17 [95% CI, 1.11-1.23]), and 39 weeks 0 days to 41 weeks 6 days\u2019 gestation (adjusted HRs, 1.23 [95% CI, 1.16-1.30] and 1.31 [95% CI, 1.22-1.40]). However, ACS-exposed children born at 28 weeks 0 days to 31 weeks 6 days\u2019 gestation and 32 weeks 0 days to 33 weeks 6 days\u2019 gestation showed no association between ACS exposure and respiratory and nonrespiratory infections.<\/jats:p><\/jats:sec>Conclusion and Relevance<\/jats:title>In this cohort study, exposure to ACS was associated with increased risks of infections in full-term children until age 21 years. In preterm children born before 34 weeks\u2019 gestation, no association between ACS and infections was found. To minimize the adverse effects of ACS treatment, more stringent criteria for ACS administration and better prediction tools for preterm birth are required.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.36809","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T15:00:36Z","timestamp":1760367636000},"page":"e2536809","source":"Crossref","is-referenced-by-count":4,"title":["Antenatal Corticosteroids and Infectious Diseases Throughout Childhood"],"prefix":"10.1001","volume":"8","author":[{"given":"Fabienne","family":"Decrue","sequence":"first","affiliation":[{"name":"Centre for Cardiovascular Science, Queen\u2019s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily M.","family":"Frier","sequence":"additional","affiliation":[{"name":"Medical Research Council Centre for Reproductive Health, University of Edinburgh, Edinburgh, United 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