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Related Experiment Videos

Neonatal adrenal function after repeat dose prenatal corticosteroids: a randomized controlled trial.

Patricia J Ashwood1, Caroline A Crowther, Kristyn J Willson

  • 1Department of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia.

American Journal of Obstetrics and Gynecology
|March 9, 2006
PubMed
Summary

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Repeat prenatal corticosteroids did not affect cord serum cortisol but did lower adrenal response to stress and cortisol levels on day 7 in preterm infants. Clinical impact requires further study.

Area of Science:

  • Neonatal endocrinology
  • Perinatal medicine
  • Reproductive biology

Background:

  • Prenatal corticosteroid administration accelerates fetal lung maturation.
  • Repeat courses of antenatal corticosteroids are used in women at risk of preterm birth.
  • Potential effects of repeat courses on neonatal adrenal function are not fully understood.

Purpose of the Study:

  • To determine if repeat prenatal corticosteroid administration suppresses neonatal cortisol concentrations.
  • To investigate the impact of repeat prenatal corticosteroids on adrenal function in infants born preterm.

Main Methods:

  • Randomized controlled trial comparing weekly repeat corticosteroids versus saline placebo.
  • Participants were women at risk of preterm birth, treated until 32 weeks' gestation.

Related Experiment Videos

  • Neonatal cortisol concentrations were measured in cord serum and salivary samples at various time points (days 3, 7, 14, 21), including response to a stressor.

    • Main Results:

    • Cord serum cortisol concentrations were similar between repeat corticosteroid and single course groups.
    • Prestress salivary cortisol on day 3 was also similar between groups.
    • The adrenal response to a stressor on day 3 was lower in the repeat corticosteroid group (P = .02).
    • Cortisol concentrations were lower on day 7 in the repeat corticosteroid group (P = .04), but not on later days.

    Conclusions:

    • Repeat prenatal corticosteroids may alter neonatal adrenal function, specifically reducing the stress response and early cortisol levels.
    • The clinical significance of these observed changes in adrenal function requires further investigation.
    • Long-term effects on infant health and development remain to be determined.