Placental transfer of methylprednisolone following maternal intravenous administration

Investigation of the maternal to foetal serum concentration gradient of dexamethasone in the rat

“…Clinical reports of lower concentrations of dexamethasone (Kream et al, 1983), methylprednisolone (Anderson et al, 1981), betamethasone (Ballard et al, 1975) and certain antibiotics (see, Duignan et al, 1973) in the cord than in the maternal blood could also be indicative of a similar active placental transfer mechanism, provided these concentration differences are not reflections of relatively lower protein binding in the foetal blood. If an active placental transfer mechanism does exist in humans, it can be a potential site of interaction between certain types of drugs.…”

Infants Born to Mothers With Severe Acute Respiratory Syndrome

“…Although methylprednisolone crosses the placenta less readily than dexamethasone or betamethasone, a pharmacokinetic study has shown that therapeutic levels of methylprednisolone were reaching the fetal compartment in its active form after a single intravenous injection (methylprednisolone, 125 mg) was administered antenatally. 9 Therefore, a considerable amount of methylprednisolone would have entered the fetal circulation of our infants, considering the very high maternal dose used in this series. Early (Ͻ96 hours of birth) postnatal systemic dexamethasone treatment has been associated with an increased risk of spontaneous upper gastrointestinal perforation but not NEC in very low birth weight infants.…”

A complicated multisystem flare of systemic lupus erythematosus during pregnancy

“…Azathioprine is also safe and should be considered in treatment regimens prior to conception, along with aspirin. Steroids are often used in pregnancy as they are not associated with congenital abnormalities,15 but can be associated with premature rupture of membranes, preterm delivery and maternal sepsis 16. Tacrolimus is safe in pregnancy,17 and breast feeding,18 and may be a useful alternative or adjunctive therapy for LN flare during pregnancy 19.…”