Neonatal hypoglycemia associated with the antenatal corticosteroids may be secondary to fetal adrenal suppression

Aydın, Mustafa; Deveci, Uğur; Hakan, Nilay

doi:10.3109/14767058.2014.936002

Cited by 10 publications

(7 citation statements)

References 5 publications

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“…Despite the well‐established beneficial effects of ACS, its utilization may be associated with various adverse perinatal outcomes including decreased birth weight and head circumference 5,6 . In addition, increased risk of neonatal hypoglycemia was observed after ACS administration, 7,8 plausibly due to maternal hyperglycemia or fetal adrenal suppression 8–11 12 …”

Section: Introductionmentioning

confidence: 99%

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Factors associated with the development of neonatal hypoglycemia after antenatal corticosteroid administration: It's all about timing

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Erlichman

et al. 2021

Intl J Gynecology & Obste

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Preterm birth remains the leading cause of perinatal morbidity and mortality worldwide, despite significant advancements in prenatal and neonatal care. 1,2 Antenatal corticosteroid (ACS) administration to women at risk of early preterm delivery (<34 weeks of pregnancy), represents one of the most effective interventions to improve perinatal outcomes. 3,4 Despite the well-established beneficial effects of ACS, its utilization may be associated with various adverse perinatal outcomes including decreased birth weight and head circumference. 5,6 In addition, increased risk of neonatal hypoglycemia was observed after ACS administration, 7,8 plausibly due to maternal hyperglycemia or fetal adrenal suppression. [8][9][10][11] While neonatal hypoglycemia is usually easily managed by care providers, a delay in its diagnosis and

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Section: Introductionmentioning

confidence: 99%

“…5,6 In addition, increased risk of neonatal hypoglycemia was observed after ACS administration, 7,8 plausibly due to maternal hyperglycemia or fetal adrenal suppression. [8][9][10][11] While neonatal hypoglycemia is usually easily managed by care providers, a delay in its diagnosis and…”

mentioning

confidence: 99%

Factors associated with the development of neonatal hypoglycemia after antenatal corticosteroid administration: It's all about timing

Zigron

Rotem

Erlichman

et al. 2021

Intl J Gynecology & Obste

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“…However, they reported significantly higher rates of hypoglycemia in these neonates who had experienced ACS (5). Pettit et al reported the relationship between ACS use and neonatal hypoglycemia, speculating that ACS use may cause maternal hyperglycemia, which in turn leads to fetal pancreatic β-cell proliferation/hyperinsulinemia and then neonatal hypoglycemia (6). Pregnant women take large amounts of corticosteroids during pregnancy, and the drugs can pass through the placenta, resulting in inhibitory effects on the adrenal function of the fetus.…”

Section: Introductionmentioning

confidence: 99%

Effects of antenatal corticosteroids on neonatal blood glucose fluctuation in late-preterm infants

et al. 2022

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ObjectiveTo evaluate the effects of antenatal corticosteroids (ACS) on blood glucose fluctuations in late-preterm neonates.MethodsA retrospective study was performed on 236 neonates with gestational age of 34+0 to 36+6 weeks who were admitted to the neonatology department of a tertiary general hospital in China's Zhejiang Province between April 2020 and February 2022. The neonates were divided into three groups: complete course, partial course, and control. Primary outcome was the neonatal blood glucose levels within the first 48 h of life.Results134 (56.8%) newborns were exposed to a complete course of ACS, 56 (23.7%) had a to a partial course of ACS, and 46 (19.5%) had no exposure to ACS. The patients in the complete course group had the highest proportion of neonatal hypoglycemia (16.4% vs. 3.6% and 6.5%).The patients exposed to a complete course of dexamethasone had significantly lower blood glucose levels within 12 h of birth than the control group, although no significant differences were observed after 24 h. Differences in blood glucose levels were more significant among male infants, although blood glucose curves of the male and female infants remained close to the overall trend.ConclusionsBlood glucose levels in late-preterm neonates may decrease after ACS administration, especially after exposure to a complete course. The effects are more pronounced in the first 12 h of life, with males being more severely affected; however, the effects on blood glucose levels were not significant 24 h after birth. This can provide a reference for future clinical studies.

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“…[2,3] Another proposed mechanism of antenatal steroid resulting in neonatal hypoglycemia is through direct suppression of fetal adrenal glands, as reported by Saulnier and Kurtoglu. [4] Prematurity by itself is already a risk for neonatal hypoglycemia. In a study about neonatal glucose screening among later preterm deliveries, more than 50% developed hypoglycemia, while 19% developed severe hypoglycemia.…”

Section: Introductionmentioning

confidence: 99%

The Association of Antenatal Steroids and Hypoglycemia in Preterm Neonates

Cunanan¹

2021

JMUST

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Objective Antenatal steroids have shown to decrease the rate of neonatal complications and morbidity; however, neonates are predisposed to significant hypoglycemia resulting in invasive interventions and prolonged nursery admissions. The risk of hypoglycemia in the preterm has been well studied, but the association of antenatal steroids and hypoglycemia in preterm neonates has not been well explored. Thus, we sought to determine the association of antenatal steroids given to mothers who delivered prematurely and the development of neonatal hypoglycemia. Methods A cross-sectional study using chart review was done on mother–preterm neonate pairs admitted in the charity obstetrical ward of The University of Santo Tomas Hospital from January 1, 2018 to December 31, 2019. The subjects were mothers either given or not given antenatal steroids before preterm delivery and their respective neonates. The provision of antenatal steroids was the primary exposure, while neonatal hypoglycemia was the primary outcome. Measurement of association was done using odds ratios. Univariate and multivariate logistic regression analyses were done. Results Of the 69 preterm neonates included in the study, hypoglycemia was observed in 14 neonates, among which 8 neonates were exposed to antenatal steroids. After examining the association using Fisher’s exact formula and controlling for potential confounders, neonatal hypoglycemia was not significantly higher among neonates exposed to antenatal steroids. Conclusion Antenatal steroids given to mothers who delivered preterm were not associated with the development of neonatal hypoglycemia. A prospective study model, larger population size and longer study coverage should be made to strengthen the outcome of the study.

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Neonatal hypoglycemia associated with the antenatal corticosteroids may be secondary to fetal adrenal suppression

Cited by 10 publications

References 5 publications

Factors associated with the development of neonatal hypoglycemia after antenatal corticosteroid administration: It's all about timing

Factors associated with the development of neonatal hypoglycemia after antenatal corticosteroid administration: It's all about timing

Effects of antenatal corticosteroids on neonatal blood glucose fluctuation in late-preterm infants

The Association of Antenatal Steroids and Hypoglycemia in Preterm Neonates

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