Role of corticosteroids in neonatal blood pressure homeostasis

Corticosteroids are commonly administered during the perinatal period because of their diverse actions on various organ systems, both at the cellular and molecular level, and because of their effect on maturational physiology. In particular, in situations of refractory cardiovascular collapse, corticosteroids are used by many clinicians as a last-chance therapeutic modality. This article reviews the mechanism of neonatal blood pressure homeostasis with particular emphasis on the postnatal adaptation of the neonate's cardiovascular system and adrenal function to extrauterine life. Evidence also is provided about the existence of a hypocortisolism state in the sick or stressed very low birth weight infant.