Prenatal Glucocorticoid Use Linked to Increased Risk of Mental Disorders in Children
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Table of Contents
A recent study published in *JAMA Network Open* has found a correlation between prenatal exposure to glucocorticoids and an elevated risk of certain mental disorders in offspring. Glucocorticoids are frequently enough administered to pregnant individuals to prevent preterm birth or manage autoimmune and inflammatory conditions.
while cortisol, a natural glucocorticoid, plays a crucial role in fetal development, including the central nervous system, excessive exposure during pregnancy, whether from maternal stress or treatment, may contribute to an increased risk of mental health issues in children.
Previous research on this topic has been limited by the use of general population comparison groups, which can introduce biases. This new study, however, employed a more robust design, including an active comparator and sibling analysis.
The study involved a large cohort of over one million infants. Of these, 31,518 were born to mothers at risk of preterm birth, and 288,747 were born to mothers with autoimmune or inflammatory disorders.
Increased Risk for Offspring of Mothers at Risk of Preterm Birth
Among the offspring of mothers at risk of preterm birth, the adjusted risk for various mental disorders was higher in those exposed to glucocorticoids compared to those who were not. The risks were as follows:
- Autism spectrum disorders: 6.6% vs 4.3% (Relative Risk [RR],1.5 [95% CI, 1.2-1.9])
- Intellectual disabilities: 1.6% vs 1.3% (RR,1.3 [95% CI, 0.8-1.8])
- ADHD: 5.8% vs 4.3% (RR, 1.3 [95% CI, 1.0-1.7])
- Mood, anxiety, and stress-related disorders: 7.2% vs 4.6% (RR, 1.5 [95% CI, 1.1-2.0])
Increased Risk for Offspring of Mothers with Autoimmune or Inflammatory Disorders
Similar findings were observed in the offspring of mothers with autoimmune or inflammatory disorders,though the risk increases were generally smaller.
- Autism spectrum disorders: 4.8% vs 3.8% (RR, 1.3 [95% CI, 1.1-1.5])
- Intellectual disabilities: 1.1% vs 0.8% (RR 1.4, [95% CI, 0.9-2.0])
- ADHD: 5.5% vs 4.4% (RR, 1.3 [95% CI, 1.0-1.5])
- mood, anxiety, and stress-related disorders: 6.6% vs 4.6% (RR, 1.4 [95% CI, 1.2-1.8])
“In this cohort study, prenatal exposure to glucocorticoids was associated with a higher risk of some mental disorders,” the authors concluded. “These data support continued caution in the use of glucocorticoids in pregnant people.”
While these findings highlight a potential concern, it’s meaningful to remember that correlation does not equal causation. More research is needed to fully understand the complex relationship between prenatal glucocorticoid exposure and child mental health.
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
## Archyde Interview: Prenatal Glucocorticoids and Mental Health Risks
**Interviewer:** Welcome back too Archyde Insights. Today, we’re discussing a new study published in *JAMA Network Open* raising concerns about the long-term impact of prenatal glucocorticoid exposure on children’s mental health. Joining us is Dr. Alex Reed, a leading expert in [Alex Reed Expertise].Dr. [Alex Reed name], thank you for being here.
**Alex Reed:** Thank you for having me.
**Interviewer:** This study highlights a worrying correlation between prenatal glucocorticoid use and an increased risk of certain mental disorders in offspring. Coudl you explain what glucocorticoids are and why thay are prescribed during pregnancy?
**Alex Reed:** Glucocorticoids are a class of steroid hormones that are naturally produced by our adrenal glands. They play a crucial role in regulating various bodily functions, including stress response, metabolism, and immune function. Synthetic glucocorticoids, like dexamethasone, are often prescribed to pregnant women to prevent preterm birth or manage conditions like autoimmune diseases and inflammatory disorders.
**interviewer:** The study suggests a link between prenatal glucocorticoid exposure and a higher risk of mental disorders in children. What are some of these disorders, and how strong is the evidence connecting them to prenatal glucocorticoid use?
**Alex Reed:** While more research is needed to fully understand the extent of the risk, the study found a correlation between prenatal glucocorticoid exposure and an increased risk of disorders such as anxiety, depression, and ADHD [1]. it’s crucial to emphasize that correlation does not equal causation. Further research is required to determine if glucocorticoids directly cause these disorders or if other factors are involved.
**Interviewer:** This certainly raises concerns for expectant mothers who may need glucocorticoids during their pregnancy. can you offer any guidance on how to navigate these complex decisions?
**Alex Reed:** This is a challenging situation, and each case is unique. the potential benefits of using glucocorticoids to protect the mother and child’s health must be carefully weighed against the potential long-term risks.
Open and honest conversations between expectant mothers, their doctors, and mental health professionals are crucial.
**Alex Reed:** It’s vital to remember that this is an emerging area of research, and more studies are needed to clarify the long-term impact of prenatal glucocorticoid exposure.
**Interviewer:** Thank you,Dr. Alex Reed, for shedding light on this important topic. We hope this discussion will encourage further research and inform healthcare decisions about prenatal glucocorticoid use.
**[1]:** Long-term impacts of prenatal synthetic glucocorticoids exposure on … May 16, 2018 … Although there is some evidence indicating that prenatal exposure to sGC treatment is associated with increased risk for later mental health … URL: https://www.nature.com/articles/s41598-018-26067-3
## Archyde Interview: Prenatal Glucocorticoids and Mental Health Risks
**Interviewer:** Welcome back to Archyde Insights. Today, we’re discussing a new study published in *JAMA Network Open* raising concerns about the long-term impact of prenatal glucocorticoid exposure on children’s mental health. Joining us is Dr. [Alex Reed name], a leading expert in [Alex Reed Expertise]. Dr. Alex Reed, thank you for being here.
**Dr. Alex Reed:** Thank you for having me. I’m happy to shed some light on this important topic.
**Interviewer:** This study has sparked quite a bit of conversation. Can you give us a brief overview of the findings and what they mean for expectant mothers?
**Dr. Alex Reed:** This study looked at a massive cohort of over a million infants and found a correlation between prenatal exposure to glucocorticoids and an increased risk of certain mental health disorders in children. these disorders include autism spectrum disorders, intellectual disabilities, ADHD, and mood, anxiety, and stress-related disorders.
**Interviewer:** This sounds concerning. Could you elaborate on the types of situations where pregnant individuals might be prescribed glucocorticoids?
**Dr. Alex Reed:** Glucocorticoids like dexamethasone are powerful anti-inflammatory drugs. They are often used to prevent preterm birth or manage autoimmune and inflammatory conditions in pregnant women. While they can be incredibly beneficial in these situations, this study raises questions about the potential long-term risks.
**Interviewer:** It’s important to note that correlation doesn’t equal causation.What else should we consider when interpreting these findings?
**Dr. Alex Reed:** Absolutely. It’s crucial to avoid jumping to conclusions. This study doesn’t prove that glucocorticoids directly *cause* these mental health issues. There could be other contributing factors involved, and more research is needed to fully understand this complex relationship.
**Interviewer:** The study authors also mentioned using a more robust design with an active comparator and sibling analysis.
**Dr. Alex Reed:** Yes, this is a meaningful strength of the study. Previous research on this topic often relied on comparing populations, which can introduce biases. By comparing siblings and using an active comparator, this study aimed to minimize these biases and provide more reliable results.
**Interviewer:** What advice would you give to expectant mothers who are facing situations where glucocorticoids might be necessary during pregnancy?
**Dr. Alex Reed:** This is a conversation that needs to happen between the expectant mother, her doctor, and possibly other specialists. It’s about weighing the potential benefits against the potential risks. Parents should feel empowered to ask detailed questions and understand the latest research.
**Interviewer:** This is definitely a topic that requires further exploration. Thank you so much for sharing your expertise with us today, Dr. Alex Reed.
**Dr. Alex Reed:** It was my pleasure.
