Long-Term Safety of Antenatal Corticosteroids: Insights from the 50-Year Follow-Up of the Auckland Steroid Trial

Study Background and Disease Burden

Antenatal corticosteroids, primarily betamethasone, are routinely administered to pregnant individuals at risk for preterm birth, aiming to mitigate neonatal morbidity, notably respiratory distress syndrome. Despite this clinical benefit, there has been growing concern regarding the potential long-term adverse effects of these medications on subsequent generations. Previous animal studies have identified endocrine and metabolic disruptions in both the first (F1) and second generations (F2) following in utero exposure to corticosteroids. These findings highlight the necessity for human studies to evaluate the safety and long-term health implications of antenatal corticosteroid exposure in humans.

The Auckland Steroid Trial (AST), conducted in the late 1970s and early 1980s, initially sought to examine the safety and efficacy of antenatal betamethasone in preventing respiratory complications in premature infants. However, the unexpected potential for transgenerational effects prompted further examination into the health outcomes of the F2 generation, primarily those whose mothers were randomized to receive either betamethasone or placebo.