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Repetitive prenatal glucocorticoids improve lung function and decrease growth in preterm lambs

M Ikegami¹, A H Jobe, J Newnham

¹Perinatal Research Laboratories, Harbor-UCLA Medical Center, Torrance, USA.

American Journal of Respiratory and Critical Care Medicine

|July 1, 1997

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Multiple fetal glucocorticoid treatments improved lamb lung function but reduced birth weight. This study highlights the complex trade-offs of prenatal steroid exposure on neonatal development and endocrine balance.

Area of Science:

Perinatology
Developmental Biology
Pulmonology

Background:

Prenatal exposure to glucocorticoids is used to accelerate fetal lung maturation.
The effects of multiple antenatal glucocorticoid exposures on postnatal development remain incompletely understood.

Purpose of the Study:

To investigate the impact of repeated fetal glucocorticoid administration on postnatal lung function and growth in preterm lambs.
To assess alterations in endocrine profiles following multiple prenatal glucocorticoid treatments.

Main Methods:

Ewes received 1-4 doses of betamethasone or placebo between 104 and 124 days of gestation.
Lambs were delivered preterm at 125 days gestation.
Postnatal lung function, growth parameters, and plasma hormone levels were evaluated.

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Main Results:

Sequential improvements in lung compliance, ventilation efficiency, and lung volumes were observed with increasing doses of antenatal betamethasone.
A four-fold increase in lung volume and 150% increase in compliance were noted after four doses.
Significant reductions in birth weight occurred, alongside altered postnatal cortisol, thyroid, and catecholamine levels.

Conclusions:

Repetitive antenatal glucocorticoid exposure progressively enhances fetal lung function but leads to adverse effects on growth and endocrine regulation.
The findings suggest a dose-dependent relationship and potential trade-offs between lung maturation and overall development with repeated prenatal steroid treatments.