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Prenatal exposure to oral glucocorticoids and risk of long-term neurodevelopmental disorders

T. Oh,I. Song

Published 2026 in Scientific Reports

ABSTRACT

We investigated whether prenatal exposure to oral glucocorticoids (GCs) is associated with long-term neurodevelopmental disorders (LNDDs) in offspring. Using South Korea’s National Health Insurance Service database, we identified all live births from January 1, 2011, to December 31, 2014 (n = 1,553,505) and followed offspring through December 31, 2023. Maternal oral GC exposure during pregnancy defined the exposed group. After 1:10 propensity-score matching, 33,940 exposed and 338,921 unexposed offspring were analyzed. LNDD incidence was 11.5% in the GC group versus 9.8% in the unexposed group (odds ratio [OR] 1.20, 95% confidence interval [CI], 1.16–1.24; P < 0.001). In duration analyses from the full cohort, adjusted odds were 1.06 (95% CI, 1.05–1.08; P < 0.001) for 1–6 days and 1.13 (95% CI, 1.08–1.19; P < 0.001) for ≥ 7 days versus none. By timing, adjusted odds were 1.21 (95% CI, 1.15–1.27; P < 0.001) for first, 1.16 (95% CI, 1.07–1.26; P < 0.001) for second, and 1.21 (95% CI, 1.14–1.28; P < 0.001) for third trimester exposure. Prenatal exposure to oral GCs was associated with a modest increase in LNDD risk; given the observational design and potential residual confounding, these findings are hypothesis-generating and should inform—rather than prescribe—clinical decision-making.

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