Impact of antenatal corticosteroid exposure on thymus size in premature infants

• Published in: Archives de pédiatrie : organe officiel de la Société française de pédiatrie 2022-01, Vol.29 (1), p.67-71
• Main Authors: Kilicdag, Hasan, Torer, Birgin, Demir, Senay, Hanta, Deniz, Akbas, Tugana, Mert, Mustafa Kurthan, Soker, Gokhan
• Format: Article
• Language: English
• Subjects: Adrenal Cortex Hormones - adverse effects; Adrenal Cortex Hormones - therapeutic use; Antenatal corticosteroids; Female; Gestational Age; Humans; Infant; Infant, Low Birth Weight; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Pregnancy; Premature Birth; Prenatal Care; Preterm infant; Prospective Studies; Thymic index; Thymic size; Thymus Gland - diagnostic imaging; Thymus Gland - drug effects; Thymus Gland - growth & development; Thymus/weight index; Ultrasonography, Prenatal
• ISSN: 0929-693X; 1769-664X
• DOI: 10.1016/j.arcped.2021.09.015

This study examined the effect of corticosteroids on the thymic index (TI) and the thymus/weight index (TWI) in infants exposed to antenatal corticosteroids (ACS). This prospective study was conducted between August 2014 and October 2018. A thymus ultrasound was performed to assess thymus size on the second day of life. Thymus size was assessed as TI and TWI. In total, 167 neonates (≤34 weeks gestation)  constituted the study population, including 94 ACS-exposed infants and 73 untreated infants. The treatment group exhibited significantly lower birth weight and significantly shorter birth length than the ACS (−) group. Therefore, TI was smaller in the treatment group than in the untreated group (6.96 ± 4.05 cm3 vs. 5.64 ± 3.39 cm3). The TWI was 3.69 ± 1.8 cm3/kg in the ACS (−) group versus 3.32 ± 1.56 cm3/kg in the ACS (+) group. The median anteroposterior diameter of the right lobe was 1.33 cm (range, 0.45–2.40) in the ACS (−) group compared to 1.15 cm (range, 0.47–2.40) in the ACS (+) group. The median anteroposterior diameter of the left lobe was 1.40 cm (range, 0.43–2.20) in the ACS (−) group and 1.19 cm (range, 0.32–2.36) in the ACS (+) group. The median largest sagittal area was 2.64 cm2 (range, 0.5–5.46) in the ACS (−) group versus 2.20 cm2 (range, 0.55–5.90) in the ACS (+) group. We found that TWI was not significantly changed by ACS exposure in premature infants.