Impact of antenatal corticosteroid exposure on thymus size in premature infants - 09/11/21

Doi : 10.1016/j.arcped.2021.09.015

Hasan Kilicdag ^a,^⁎ , Birgin Torer ^b, Senay Demir ^c, Deniz Hanta ^d, Tugana Akbas ^e, Mustafa Kurthan Mert ^f, Gokhan Soker ^g
^a Division of Neonatology, Department of Pediatrics, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey
^b Division of Neonatology, Department of Pediatrics, Baskent University, Adana, Turkey
^c Department of Radiology, Baskent University, Adana, Turkey
^d Division of Neonatology, Department of Pediatrics, Adana Delivery and Child Disease Hospital, Adana, Turkey
^e Department of Radiology, Acibadem Hospital, Adana, Turkey
^f Division of Neonatology, Department of Pediatrics, Numune Education and Research Hospital, Adana, Turkey
^g Department of Radiology, Numune Education and Research Hospital, Adana, Turkey

^⁎Corresponding author: Acibadem Mehmet Ali Aydinlar University School of Medicine, Kerem Aydınlar Kampüsü Kayışdağı Cad. No: 32 PK: 34752 Ataşehir /İstanbul, Turkey.Acibadem Mehmet Ali Aydinlar University School of MedicineKerem Aydınlar Kampüsü Kayışdağı Cad. No: 32 PK: 34752 Ataşehir /İstanbulTurkey

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Abstract

Background

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).

Methods

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.

Results

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.