Antenatal and early postnatal dexamethasone treatment decreases cortisol secretion in preterm infants

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R Karlsson1, J Kallio, J Toppari

  • 1Department of Pediatrics, University of Turku, Turku, Finland. riikka.karlsson@utu.fi

Hormone Research
|October 25, 2000
PubMed

Insights

Antenatal and postnatal corticosteroid treatments (ACT and PCT) significantly lower serum cortisol levels in preterm infants. These treatments did not affect catecholamine or cAMP levels, indicating a notable impact on basal cortisol regulation.

Area of Science:

  • Neonatal Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Glucocorticoids are vital for fetal development, aiding respiratory and cardiovascular maturation.
  • Antenatal corticosteroid treatment (ACT) and postnatal corticosteroid treatment (PCT) are used to manage preterm infants, particularly for respiratory distress syndrome.
  • The impact of these treatments on neonatal endocrine function requires further investigation.

Purpose of the Study:

  • To investigate the effects of ACT and early PCT on serum cortisol, plasma catecholamines, and adenosine 3',5'-cyclic monophosphate (cAMP) in preterm neonates.
  • To assess the duration of cortisol suppression following PCT discontinuation.

Main Methods:

  • Preterm neonates received either ACT or no ACT.
  • Infants were further divided into PCT and non-PCT groups postnatally.
  • Serum cortisol, plasma catecholamine, and cAMP levels were measured.
  • Hormonal concentrations were analyzed in relation to treatment groups and time points.

Main Results:

  • Infants receiving ACT showed significantly lower serum cortisol on day 1 of life compared to controls.
  • PCT significantly suppressed cortisol levels within 2 days.
  • Cortisol levels remained suppressed for 2 days after PCT discontinuation.
  • No significant effects of PCT were observed on plasma catecholamine or cAMP concentrations.

Conclusions:

  • Both ACT and short-term PCT can significantly suppress basal serum cortisol levels in preterm infants.
  • The endocrine effects of corticosteroid treatment in neonates are primarily on cortisol regulation.
  • Further research may explore long-term implications of this suppression.

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