Effect of exogenous corticosteroids on the developing central nervous system: a review.
Corticosteroid therapy is used in a variety of developmental clinical settings. Prenatally, maternal administration of corticosteroids is used primarily in the prevention of respiratory distress syndrome. Postnatally, corticosteroids are used to treat a variety of infant diseases such as autoimmune hemolytic anemia and hypoglycemia. Treatment regimes often involve repeated administration, on a weekly basis prenatally and daily postnatally, despite an absence of safety data from randomized clinical trials. A large number of animal studies, the majority of which used rodents, have shown that both repeated prenatal or neonatal administration of exogenous corticosteroids has a wide range of detrimental effects on the structure and function of the developing central nervous system (CNS). None of these studies included long-term follow-up. Despite the reported detrimental effects on CNS development, a number of animal studies have shown that pretreatment with corticosteroids nevertheless protect the brain from hypoxia-ischemic injury; however, clinically such treatment is no longer favored. Studies using large animal models and with long-term follow-up should be undertaken to establish the relative risks and benefits of the repeated application of exogenous corticosteroids.
Huang
W L
WL
Department of Zoology, University of Western Australia, Nedlands, Australia. wenlong@cyllene.uwa.edu.au
Dunlop
S A
SA
Harper
C G
CG
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D000818:Animals; D002490:Central Nervous System / Q000187:drug effects* / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D011295:Prenatal Care
D000305:Adrenal Cortex Hormones