Prenatal Glucocorticoids Linked to Increased Risk of Mental Disorders in Children
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A groundbreaking study published in JAMA Network Open has revealed a significant association between prenatal exposure to glucocorticoids and an elevated risk of several mental health disorders in offspring. The research, involving a massive dataset of over one million infants, highlights a crucial concern for expectant mothers and healthcare providers alike.
Glucocorticoids, a class of steroid hormones, are often prescribed during pregnancy to manage conditions like preterm labor and autoimmune disorders. While these medications can be life-saving for both mother and child,this study suggests potential long-term consequences for the child’s mental well-being.
the authors of the study emphasize the critical role of cortisol, a natural glucocorticoid, in fetal progress, especially the central nervous system (CNS).”Cortisol, an endogenous glucocorticoid, plays a critical role in normal fetal development, including development of the central nervous system (CNS),” they wrote. “However, prenatal exposure to excess glucocorticoid levels (maternal stress or treatment) may increase the risk of mental disorders in offspring via multiple mechanisms.”
The research team analyzed data from 1,061,548 infants, wiht 52% being male. The study meticulously compared children whose mothers received glucocorticoid treatment during pregnancy to those who did not, controlling for various factors. The results revealed statistically significant increases in the risk of several mental health conditions in the exposed group.
increased Risks Observed
For children whose mothers were at risk of preterm delivery and received glucocorticoids, the study found increased risks for:
- Autism spectrum disorders: 6.6% vs 4.3% (relative risk [RR] of 1.5)
- Intellectual disabilities: 1.6% vs 1.3% (RR of 1.3)
- ADHD: 5.8% vs 4.3% (RR of 1.3)
- Mood, anxiety, and stress-related disorders: 7.2% vs 4.6% (RR of 1.5)
Similarly, for children whose mothers had autoimmune or inflammatory disorders and received glucocorticoids, increased risks were observed for:
- Autism spectrum disorders: 4.8% vs 3.8% (RR of 1.3)
- Intellectual disabilities: 1.1% vs 0.8% (RR of 1.4)
- ADHD: 5.5% vs 4.4% (RR of 1.3)
- Mood,anxiety,and stress-related disorders: 6.6% vs 4.6% (RR of 1.4)
While the study employed rigorous methodology, including an active comparator and sibling design, the researchers acknowledge that confounding factors related to disease severity couldn’t be entirely ruled out.
The authors concluded, “In this cohort study, prenatal exposure to glucocorticoids was associated with higher risk of some mental disorders. These data support continued caution in the use of glucocorticoids in pregnant people.”
this research underscores the importance of ongoing dialog between expectant mothers and their healthcare providers regarding the risks and benefits of glucocorticoid treatment during pregnancy. Further research is needed to fully understand the complex interplay between prenatal glucocorticoid exposure and the development of mental health disorders.
Reference: Laugesen K, skajaa N, Petersen I, et al. Mental Disorders among Offspring Prenatally Exposed to Systemic Glucocorticoids. JAMA Netw Open. 2025;8(1):e2453245. doi:10.1001/jamanetworkopen.2024.53245
Prenatal Steroid use and Child Mental Health: A Cause for Concern?
This interview explores the findings of a groundbreaking study published in JAMA network Open which reveals a potential link between prenatal exposure to glucocorticoids and an increased risk of mental health disorders in children. We are joined by Dr. Emily carter, a leading expert in maternal-fetal medicine and child progress, to discuss the implications of this research.
Understanding the Study’s Findings
Senior Editor: Dr. Carter,can you elaborate on the findings of this study regarding prenatal glucocorticoid exposure and child mental health?
Dr. Emily Carter: Certainly. This large-scale study analyzed data from over a million infants, comparing those whose mothers received glucocorticoids during pregnancy to those who did not. The results showed a statistically meaningful increase in the risk of several mental health disorders in the exposed group, including autism spectrum disorders, intellectual disabilities, ADHD, and mood and anxiety disorders.
Senior Editor: These are serious concerns. Can you explain a bit about why glucocorticoids might have this effect?
Dr. Emily Carter: Glucocorticoids are a class of steroid hormones, and while they play a vital role in fetal development, including the development of the central nervous system, excessive exposure, especially during critical periods of brain development, may disrupt this process.
The Role of Cortisol and Prenatal Stress
Senior Editor: The study mentions cortisol, a natural glucocorticoid.could you shed some light on its role?
Dr. Emily Carter: Cortisol is crucial for normal fetal development. However, both maternal stress, which can elevate cortisol levels, and medical treatment with glucocorticoids can result in excessive exposure. This can potentially negatively impact brain development and increase the risk of mental health issues later in life.
Balancing Risks and Benefits
Senior Editor: This research raises vital questions about the use of glucocorticoids during pregnancy. How can expectant mothers and healthcare providers weigh the potential risks against the benefits?
Dr. Emily Carter: It’s crucial to have open and honest discussions about the risks and benefits. Glucocorticoids can be life-saving in situations like preterm labour or autoimmune disorders, but this study highlights the need for careful consideration and potentially exploring option treatments when possible.
Moving Forward
Senior Editor: What are the key takeaways from this research, and what future studies are needed?
Dr. emily Carter: This study underscores the importance of ongoing research into the long-term effects of prenatal glucocorticoid exposure. We need more research to understand the dose-response relationship, identify potential mitigating factors, and develop strategies to minimize risks while ensuring the well-being of both mothers and their children.
