CIHR funds Jennifer Hutcheon and her team to assess the consequences of antenatal corticosteroid use on child brain development using a novel research methodology

Dr Jennifer Hutcheon was awarded a $221,850 CIHR Project Grant for her study “Short term benefits but long term harm? Assessing the consequences of antenatal corticosteroid administration for child neurodevelopment” which aims to establish if antenatal corticosteroids have harmful consequences for child brain development.

Although antenatal corticosteroids, a medication given to pregnant women at risk of preterm delivery, are proven to be helpful for babies’ lung development at the time of birth, there are growing concerns that they may also harm children’s longer-term brain development. Doctors are becoming reluctant to use the medication without a better understanding of its long-term safety. Working with co-principal applicants Drs. Erin Strumpf, health services researcher, and Sam Harper, health policy researcher, from the Department of Epidemiology, Biostatistics and Occupational Health at McGill University and co-investigators Dr Amanda Skoll, Associate Professor, UBC Department of Obstetrics and Gynaecology, and Myriam Srour, PhD pediatric neurologist at the Montreal Children’s Hospital and McGill University– Dr Hutcheon will analyse 15 years worth of records from hospital deliveries, childhood physician visits, and kindergarten testing using a novel analytical approach called regression discontinuity (RD).

When a randomized trial design—the gold standard approach for understanding the effects of a medication on child health — is not feasible, RD studies can help to estimate the consequences of a medication using existing data. The design uses differences in care immediately on either side of a clinical cut-point as kind of randomization.

In the case of antenatal corticosteroids, current guidelines recommend administration up to 33 weeks+ 6 days’ gestation – but not one day later, at 34 weeks+ 0 days, so infants born as little as hours apart have substantially different chances of receiving the treatment. This difference in practice will help Dr Hutcheon and her team to isolate the effects of antenatal corticosteroid use on child health from other potential causes of poor brain development.

With this new CIHR funding they plan to establish if antenatal corticosteroids have harmful consequences for child brain development – such as lower kindergarten assessment scores, cerebral palsy, or attention deficit hyperactivity disorder – in the longer term.

The results from this research will help to ensure that women and their doctors are able to make fully informed decisions on use of this effective medication to balance both short and longer-term child health.

Congratulations to Dr Hutcheon and her team! We look forward to learning more in the future.