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Infant cortisol response after prolonged antenatal prednisolone treatment

N M Miller1, C Williamson, N M Fisk

  • 1Wolfson and Weston Research Centre for Family Health, Institute of Reproductive and Developmental Biology, Faculty of Medicine, Imperial College London, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|January 25, 2005
PubMed

Insights

Antenatal prednisolone use in pregnancy appears safe for infants. This study found no significant differences in birthweight or cortisol levels, offering initial reassurance for this common treatment.

Area of Science:

  • Perinatal medicine
  • Pediatric endocrinology
  • Reproductive health

Background:

  • Prednisolone is frequently prescribed during pregnancy for various conditions.
  • Long-term infant safety data for antenatal prednisolone exposure is limited.
  • Animal studies suggest potential risks like growth restriction and altered HPA axis function.

Purpose of the Study:

  • To evaluate the safety of antenatal prednisolone exposure in infants.
  • To assess infant growth and hypothalamic-pituitary-adrenal (HPA) axis response following in utero exposure.

Main Methods:

  • Recruitment of pregnant women receiving antenatal prednisolone.
  • Follow-up of 12 infants up to four months of age.
  • Measurement of infant birthweights, baseline cortisol, and stress-induced cortisol levels (using vaccinations as a stressor).
  • Comparison with a control group (n=289) of uncomplicated pregnancies.

Main Results:

  • Infant birthweights were comparable between the prednisolone-exposed group and controls.
  • Both baseline and stress-induced cortisol levels in infants did not differ significantly from controls.
  • Mothers reported their infants exposed to prednisolone as less difficult and more adaptable.

Conclusions:

  • This study provides initial evidence supporting the safety of antenatal prednisolone treatment in pregnancy.
  • No adverse effects on infant growth or HPA axis function were detected in this cohort.
  • Further long-term studies are warranted, but findings offer reassurance for clinical practice.

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