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Published on: November 20, 2015
Glucocorticoids and preterm hypoxic-ischemic brain injury: the good and the bad
Laura Bennet1, Joanne O Davidson, Miriam Koome
1Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland 1142, New Zealand. l.bennet@auckland.ac.nz
Insights
Maternal synthetic glucocorticoid treatment for premature delivery risk reduces neonatal complications but its long-term neurodevelopmental effects remain unclear, warranting further investigation into brain development impacts.
Area of Science:
- Perinatology
- Neonatal Medicine
- Neuroscience
Background:
- Synthetic glucocorticoids are routinely given to mothers at risk of premature delivery.
- These treatments significantly decrease neonatal morbidity, mortality, and intraventricular hemorrhage after birth.
Purpose of the Study:
- To review current clinical and experimental evidence on the neurodevelopmental impact of synthetic glucocorticoids.
- To highlight the need for systematic research into glucocorticoid effects on the developing brain.
Main Methods:
- Review of randomized clinical trials and experimental studies.
- Analysis of existing data on neonatal outcomes and neurodevelopmental trajectories.
Main Results:
- Established benefits in reducing acute neonatal complications.
- Uncertainty regarding long-term neurodevelopmental outcomes.
- Consistent association of postnatal glucocorticoids with impaired brain development.
Conclusions:
- While beneficial for acute neonatal issues, the neurodevelopmental consequences of antenatal glucocorticoid exposure require thorough investigation.
- Further systematic research is crucial to understand and mitigate potential adverse effects on brain development.
Abstract:
Fetuses at risk of premature delivery are now routinely exposed to maternal treatment with synthetic glucocorticoids. In randomized clinical trials, these substantially reduce acute neonatal systemic morbidity, and mortality, after premature birth and reduce intraventricular hemorrhage. However, the overall neurodevelopmental impact is surprisingly unclear; worryingly, postnatal glucocorticoids are consistently associated with impaired brain development. We review the clinical and experimental evidence on how glucocorticoids may affect the developing brain and highlight the need for systematic research.
