Antenatal Steroid Exposure, Aerobic Fitness, and Physical Activity in Adolescents Born Preterm with Very Low Birth Weight

Abstract

Objective: To determine whether antenatal corticosteroid exposure is associated with aerobic fitness or physical activity participation in adolescents born preterm with very low birth weight (VLBW).

Study design: Observational cohort study of 14-year-old adolescents (n = 173) born with VLBW between 1992 and 1996 at a regional perinatal center with 91 exposed to antenatal corticosteroids. Aerobic fitness was determined from peak oxygen uptake (V˙O₂peak) obtained via maximal exercise testing on a cycle ergometer. Physical activity levels for the past year and past 2 months were estimated from a questionnaire. Between-group comparisons for continuous variables were evaluated using independent t tests or Mann-Whitney U tests. Generalized linear models were used to compare differences in fitness and physical activity between those exposed to antenatal corticosteroids and not exposed to antenatal corticosteroids, with race and sex in models.

Results: Regression analysis revealed an antenatal corticosteroids × sex × race interaction for V˙O₂peak (P ≤ .001). Nonblack male adolescents exposed to antenatal corticosteroids had significantly greater V˙O₂peak than nonblack male adolescents not exposed to antenatal corticosteroids expressed relative to body mass (mean difference [95% CI]; 8.5 [2.1-15.0] mL·kg^-1·min^-1) and lean body mass (9.0 [1.1-16.9] mL·kg_{lean body mass}^-1·min^-1). No antenatal corticosteroid group differences in V˙O₂peak were evident in black male adolescents, or black and nonblack female adolescents. Male adolescents exposed to antenatal corticosteroids reported participating in significantly more total physical activity (medians: 14.6 vs 8.5) and vigorous physical activity (3.0 vs 0.95) per week for the past 2 months than male adolescents not exposed to antenatal corticosteroids.

Conclusions: Exposure to antenatal corticosteroids was associated with greater physical activity participation and aerobic fitness in adolescents with VLBW, particularly in nonblack male adolescents, which may confer health benefits in this at-risk population.

Keywords: aerobic capacity; corticosteroid; glucocorticoid; prematurity.