Faculty Opinions recommendation of Antenatal corticosteroid therapy (ACT) and size at birth: A population-based analysis using the Finnish Medical Birth Register.

Abstract Introduction Colorectal cancer (CRC) has been reported in early adulthood in patients with anorectal malformation (ARM), and therefore, the need of endoscopic controls has been discussed. The aim of this study was to assess the risk of CRC in patients with ARM. Materials and Methods This was a nationwide population-based study with data from Swedish national health care registers. All patients diagnosed with ARM born in Sweden between 1964 and 1999 were identified in the National Patient Register. The same group was followed up in the Swedish Cancer Register from birth to December 31, 2014, for occurrences of CRC. Five age- and gender-matched individuals randomly selected from the Medical Birth Register served as controls for each ARM patient born between 1973 and 1999. Results A total of 817 patients (474 males) with ARM were included and followed up from birth to the end of observational period. Time of follow-up ranged from 15 to 50 years (mean: 28 years). None of the patients was diagnosed with CRC during the observational period. One case of rectal cancer and one case of sigmoid cancer were detected among the 3,760 controls. Conclusion In our study, the risk of CRC in early adulthood in patients with ARM is low. Our result does not support routine endoscopic follow-up for patients with ARM during the first decade of life.

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Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children

Clinical Science ◽

10.1042/cs0980137 ◽

2000 ◽

Vol 98 (2) ◽

pp. 137-142 ◽

Cited By ~ 106

Author(s):

L. W. DOYLE ◽

G. W. FORD ◽

N. M. DAVIS ◽

C. CALLANAN

Keyword(s):

Blood Pressure ◽

Corticosteroid Therapy ◽

Animal Species ◽

Antenatal Corticosteroid ◽

Antenatal Corticosteroids ◽

Preterm Children ◽

Clinical Hypertension ◽

Blood Pressures ◽

The Relationship ◽

Mercury Sphygmomanometer

Antenatal corticosteroid therapy substantially improves the survival rate of preterm infants, with few side effects. Higher blood pressure in adulthood has been described in several animal species after exposure to antenatal corticosteroids, but there are no similar reports in humans. The objective of the present study was to determine the relationship between exposure to antenatal corticosteroid therapy and blood pressure at 14 years of age. This was a cohort study of 210 preterm survivors with birthweights of < 1501 g born in the Royal Women's Hospital, Melbourne, between 1 January 1977 and 31 March 1982. Blood pressure was measured in 177 subjects (84.3%) at 14 years of age with a standard mercury sphygmomanometer. Children exposed to antenatal corticosteroids (n = 89) had higher systolic and diastolic blood pressures than those not exposed to corticosteroids (n = 88) [mean difference (95% confidence interval) (mmHg): systolic, 4.1 (0.1–8.0); diastolic, 2.8 (0.05–5.6)]. However, few had blood pressure in the hypertensive range. It is concluded that antenatal corticosteroid therapy is associated with higher systolic and diastolic blood pressures in adolescence, and might lead to clinical hypertension in survivors well beyond birth.

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