Evaluation of hypothalamic-pituitary-adrenal axis in premature infants treated with dexamethasone.
Results of a national survey of the current use of steroids in newborns in 1993 showed that 95% of the neonatologists in the United States have used dexamethasone for neonates at risk for chronic lung disease. Dexamethasone therapy for a period of a week or longer is associated with suppression of the hypothalamic-pituitary-adrenal axis (HPAA) in a substantial number of premature infants. A review of our current understanding of the biochemical tests evaluating HPAA function in premature infants and suggested guidelines for HPAA evaluation and management following dexamethasone therapy are presented.
Alkalay
A L
AL
Division of Neonatology, Ahmanson Pediatric Center, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA.
Klein
A H
AH
Nagel
R A
RA
Pomerance
J J
JJ
D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D003907:Dexamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D007235:Infant, Premature, Diseases / Q000517:prevention & control*; D008797:Metyrapone; D010913:Pituitary-Adrenal System / Q000187:drug effects*; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*
D005938:Glucocorticoids; D003907:Dexamethasone; D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D008797:Metyrapone