Dynamics of the fetal adrenal, cholesterol, and apolipoprotein B responses to antenatal betamethasone therapy

Antenatal betamethasone treatment has a persisting influence on infant HPA axis regulation

“…5,[7][8][9] Although these studies demonstrated a return to normal baseline cortisol levels within a week after AB treatment, no previous studies have assessed the persisting consequences of AB exposure on the response to a physiologically relevant stressor. Evaluating such responses provides important information about HPA axis functioning.…”

“…[7][8][9] However, those studies did not assess the responsiveness of the system to a physiologic challenge and thus did not evaluate the axis' ability to react in its normal biological role. Other studies suggest that prenatal GC treatment suppresses the ability to increase cortisol production in response to a physiologic challenge or CRH stimulation, but these studies only assessed the infants during the first postnatal week 5,10 and did not assess how long this suppression persists.…”

Sex-specific alterations in placental 11β-hydroxysteroid dehydrogenase 2 activity and early postnatal clinical course following antenatal betamethasone

“…Antenatal betamethasone results in decreased maternal and fetal cortisol levels for up to 3 days after administration (23). Therefore, preterm subjects were grouped a priori into those delivered within 72 h and those delivered Ͼ 72 h of the last maternally administered betamethasone dose.…”

“…However, glucocorticoids exert a number of effects on the fetus and placenta. Antenatal betamethasone exposure results in a period of elevated glucocorticoid bioactivity (16) with decreased fetal cortisol levels secondary to central feedback on the fetal HPA axis (23). Betamethasone treatment is also associated with decreased placental vascular resistance (29) and vasodilatation of the placental circulation (7), and reductions in fetal growth have been demonstrated following repeated antenatal exposure (4).…”

6 Intrauterine corticosteroids for lung maturation: Observations of HPA axis function and cardiac autonomic balance in the neonate

“…6.1). Because these infants were born near or at term and the mean interval between glucocorticoid treatment and delivery was more than 8 weeks, it is rather unlikely that these effects may only be a transient short-term effect considering that short-term effects of antenatal glucocorticoid exposure have been described to last for about 1 week after administration (Ballard et al, 1980;Parker et al, 1996). The possibility that the decreased cortisol response in the study group would be the result of an increased conversion of cortisol to cortisone by an altered activity of the 11-beta hydroxysteroid dehydrogenase could also be excluded because cortisol and cortisone levels were strongly correlated in the study group, thus excluding this possibility.…”