Antenatal Glucocorticoid Administration and Neonatal Glycemia

Abstract

In the group of preterm newborns bom after a single dose of Celestone chronodose given to the mothers (in order to avoid RDS syndrome) mean glycemia values at the 4th and the 12th hour after birth were not very different from the values observed in preterm newborns whose mothers were not treated with any glucocorticoid. Mean glycemia levels were significantly higher in those newborns who were fed early (within 4 h after birth) and intensively as compared with the babies traditionally not fed within the first 12 h after birth. The suggestions may be drawn out that: (1) A single dose of Celestone chronodose given to the mother 12 h prior to parturition does not influence the glycemia in the newborns. (2) The early introduction of intensive feeding (e.g. according to the scheme proposed by Boehm and Beyreiss) seems to be a good possibility for diminishing the risk of the incidence of hypoglycemia in the newborns.

Blood glucose level in preterm infants after antenatal exposure to glucocorticoid

“…In two previous studies, BM-exposed infants appeared to have a higher rate of hypoglycaemia than the controls (6,16) but no difference was found in two others (7,8). Unfortunately, these studies (except one) did not report the exact interval between the drug administration and delivery.…”

“…Unfortunately, these studies (except one) did not report the exact interval between the drug administration and delivery. Furthermore, the number of studied infants has been small (6–8,16). In the present study, the last dose of Dex given less than one day before delivery had no significant association with the mean neonatal glucose levels.…”

“…The difference of 0.6 mmol/L (10 mg/100 mL) between the exposed and non‐exposed infants was considered clinically significant, and standard deviation of 1.2 was based on a previous small study (8). By choosing 5% type I error and power of 80%, we estimated the sample size to be approximately 65 in each group.…”

“…Moreover, there are very few and conflicting reports on the possible effects of antenatal glucocorticoid treatment on neonatal glucose homeostasis. In a randomized controlled trial, BM exposure increased the incidence of hypoglycaemia (6), but no difference was observed in some other studies involving the first few hours after birth (7,8). Antenatal glucocorticoid exposure prevented the development of hypoglycaemia in growth-retarded rat pups (9) and increased the rate-limiting enzyme of gluconeogenesis (10,11).…”