Prenatal Glucocorticosteroids Selectively Impair Language Development

Prenatal exposure to excessive amounts of glucocorticosteroids (GCs) adversely affects the neural development and subsequent behavior of animals (see Matthews, 2000). Despite this, women who are likely to delivery prematurely are routinely given prenatal GCs because they decrease morbidity and mortality in preterm (PT) infants. Between 1994 and 2000, there was no consensus about the optimal number of courses of GCs to give and, consequently, clinically similar pregnant women received different amounts. We took advantage of this natural experiment and investigated the impact of prenatal GCs on the development of 495 PT children and 481 full-term (FT) children who had risk factors for being born prematurely. Of the PT children, 47% received no courses of GCs, 33% received 1 course, 9% received 2 courses, and 10% received 3 or more courses (range 3-12). Of the FT children, 58% received no courses of GCs, 28% received 1 course, 6% received 2 courses, and 8% received 3 or more courses (range 3-11). Based on the animal findings, we predicted that children who received more GCs would have significantly poorer outcomes than those who received less GCs. For the PT children, there was a significant linear relationship between GCs and poorer outcome for 70% of the linguistic measures, but only 5% of the nonlinguistic outcome measures. A similar pattern was observed for the FT children, with 3 or more courses of GCs resulting in significantly worse outcome for 75% of the linguistic measures. We discuss reasons why language development appears to be more vulnerable to prenatal GCs than other areas of development. Stromswold, K. (2008). Glucocorticosteroids selectively impair language development 1 Prenatal Glucocorticosteroids Selectively Impair Language Development Karin Stromswold Rutgers University – New Brunswick