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Repeat doses of antenatal steroids and hypothalamic-pituitary-adrenal axis (HPA) function
Malcolm R Battin1, Coila Bevan, Jane E Harding
1Department of Paediatrics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
American Journal of Obstetrics and Gynecology
|July 10, 2007
Summary
Repeated courses of antenatal steroids do not impact neonatal hypothalamic-pituitary-adrenal axis function. This study found no significant differences in hormone levels or stress responses between infants receiving single or multiple steroid courses.
Area of Science:
- Neonatal Endocrinology
- Reproductive Medicine
- Pediatric Pharmacology
Background:
- Antenatal corticosteroids are crucial for fetal lung maturation.
- Concerns exist regarding the long-term effects of repeated antenatal steroid courses on the neonatal endocrine system.
Purpose of the Study:
- To compare the effects of single versus repeated antenatal steroid courses on the hypothalamic-pituitary-adrenal (HPA) axis function in neonates.
- To assess potential HPA axis suppression following multiple antenatal steroid exposures.
Main Methods:
- Observational study and randomized controlled trial data collection.
- Measurement of neonatal cortisol and adrenocorticotropic hormone (ACTH) levels.
- Performance of a metyrapone test in a subset of infants to evaluate HPA axis responsiveness.
Main Results:
- No significant differences in baseline cortisol or ACTH levels were observed between infants exposed to single or repeated antenatal steroid courses (P = .53 and P = .15).
- The cortisol response to metyrapone, indicating HPA axis function, was similar in both exposure groups (P = .46).
- Cortisol levels did decrease in response to metyrapone, confirming HPA axis activity (P = .03).
Conclusions:
- Repeated courses of antenatal steroids do not appear to cause clinically significant suppression of the neonatal hypothalamic-pituitary-adrenal axis.
- Findings suggest that multiple antenatal steroid administrations are safe concerning neonatal HPA axis function.
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