Related Experiment Video
Updated: Sep 26, 2026
Intratracheal Instillation of Stem Cells in Term Neonatal Rats
Published on: May 4, 2020
A randomized, placebo-controlled trial of effects of dexamethasone on hypothalamic-pituitary-adrenal axis in preterm
D M Wilson1, R B Baldwin, R L Ariagno
1Department of Pediatrics, Stanford University, California 94305.
Insights
Seven days of dexamethasone therapy in preterm infants with bronchopulmonary dysplasia temporarily suppressed the hypothalamic-pituitary-adrenal axis and reduced weight gain. These effects were short-lived and resolved within 10 days post-treatment.
Area of Science:
- Pediatrics
- Endocrinology
- Neonatology
Background:
- Bronchopulmonary dysplasia (BPD) is a chronic lung disease in preterm infants.
- Glucocorticoid therapy is used for BPD, but its effects on the infant endocrine system require investigation.
Purpose of the Study:
- To evaluate the impact of short-term, high-dose dexamethasone on the hypothalamic-pituitary-adrenal (HPA) axis in preterm infants with BPD.
- To assess the effect of this therapy on infant weight gain.
Main Methods:
- A blinded, randomized, placebo-controlled study involving 27 preterm infants with BPD.
- Measurement of basal and adrenocorticotropic hormone (ACTH)-stimulated cortisol levels before, immediately after, and 10 days after 7 days of dexamethasone or placebo therapy.
- Monitoring of infant weight gain during and after treatment.
Main Results:
- Dexamethasone therapy significantly decreased basal and peak cortisol concentrations immediately post-treatment.
- The cortisol response to ACTH stimulation remained equivalent between groups.
- Weight gain was markedly diminished during dexamethasone treatment but normalized 10 days after cessation.
- HPA axis function and weight gain returned to baseline levels within 10 days post-therapy.
Conclusions:
- Seven days of high-dose dexamethasone therapy in preterm infants with BPD causes transient suppression of the HPA axis and temporary reduction in weight gain.
- These endocrine and growth effects are reversible shortly after treatment discontinuation.
Abstract:
As part of a blinded, randomized, placebo-controlled study of dexamethasone therapy in 27 preterm infants with bronchopulmonary dysplasia, we investigated the effect of 7 days of high-dose glucocorticoid therapy on the hypothalamic-pituitary-adrenal axis. Before therapy the median basal cortisol concentration in all infants was 8.2 micrograms/dl (226 nmol/L). After stimulation with 1-24 ACTH, the serum cortisol concentration rose in all infants to a median concentration of 23.5 micrograms/dl (649 nmol/L), resulting in a median rise of 13.4 micrograms/dl (37 nmol/L). Immediately after 7 days of glucocorticoid therapy basal and peak cortisol concentrations were significantly decreased in the dexamethasone group. The rise in serum cortisol following 1-24 ACTH, however, remained equivalent in both groups. Ten days after the end of therapy basal and peak cortisol concentrations in the dexamethasone group had returned to levels equivalent to those seen in the placebo group. Weight gain was markedly diminished while the infants were receiving dexamethasone. Weight gains were, however, equivalent 10 days after the end of treatment. These data indicate that 7 days of dexamethasone therapy has significant but short-term effects on cortisol secretion and possibly on weight gain.
More Related Videos
06:39Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
Published on: June 13, 2021
05:13Preclinical Model of Prenatal Delta-9-Tetrahydrocannabinol Exposure to Assess Its Impact on Neurodevelopmental Outcomes
Published on: February 28, 2025
Related Concept Videos
01:11Blinding
01:19Cushing Syndrome II: Pathophysiology