237 - Association of antenatal corticosteroids with kidney function in adolescents born preterm with very low birth weight

Poster Number: 237
Publication Number: 237.243

Whitney N. Floyd, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Daniel P. Beavers, Wake Forest University, Winston-Salem, NC, United States; Elizabeth Jensen, Wake Forest University School of Medicine, Pfafftown, NC, United States; Andrew M.. South, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Lisa Washburn, Wake Forest University School of Medicine, Winston-Salem, NC, United States

Background: Antenatal corticosteroids (ANCS), given to pregnant women at risk of preterm delivery to promote fetal lung development, may adversely affect offspring kidney development based on animal models, especially if offspring develop obesity. However, clinical evidence of the long-term kidney effects is not well described.

Objective: We hypothesized that ANCS would be associated with worse kidney function, and that greater adiposity would magnify this association.

Design/Methods: Prospective cohort of 162 14-year-olds born preterm with very low birth weight (< 1500 g). Our outcomes were serum creatinine, estimated glomerular filtration rate (eGFR), and first-morning urine albumin-to-creatinine ratio (UACR). We used generalized linear models adjusted for gestational age at birth, birth weight z-score, maternal hypertensive pregnancy, maternal smoking during pregnancy, participant smoking, and average dietary fat and sodium intake, and stratified by waist-to-height ratio (WHR) ≥0.5.

Results: The cohort was 58.6% non-Black and 54.9% female; 54.9% had ANCS exposure and 31.3% had WHR ≥0.5. In adjusted analyses, ANCS was not associated with serum creatinine (β -0.01 mg/dl, 95% CL -0.06 to 0.04), eGFR (β 5.0 ml/min/1.73 m2, 95% CL -5.8 to 15.7), or UACR (β 0.7, 95% CL -10.6 to 11.9). The magnitude of the ANCS-eGFR association was greater in those with WHR ≥0.5 (β -16.8 ml/min/1.73 m2, 95% CL -31.5 to -2.1) vs. WHR < 0.5: (β 13.9 ml/min/1.73 m2, 95% CL -0.4 to 28.1), interaction p=0.02.

Conclusion(s): ANCS exposure was not associated with worse kidney function in adolescents born preterm. ANCS may be associated with lower eGFR if offspring develop greater adiposity by adolescence.