The effects of repeat doses of antenatal corticosteroids on maternal adrenal function.
OBJECTIVE
The purpose of this study was to determine whether repeated doses of maternal corticosteroids suppress the maternal hypothalamic-pituitary-adrenal axis.


METHODS
The low-dose corticotropin stimulation test (1.0 microg intravenously) was administered a median of 3 days after the last betamethasone dose to 18 pregnant women who had received at least 2 weekly courses of antenatal betamethasone and to 6 control subjects matched for gestational age who had not received antenatal corticosteroids.


RESULTS
The mean basal cortisol level was significantly depressed among women who had received betamethasone with respect to control subjects (1.9 +/- 1.5 vs 26.5 +/- 6.2 microg/dL; P <.001). The maternal cortisol level after corticotropin stimulation was significantly lower in all women who had received betamethasone (P <. 001). The mean time to attainment of peak cortisol level was significantly longer among women who had received betamethasone than among control subjects (37 +/- 6.8 vs 27.4 +/- 1.6 minutes; P <.001).


CONCLUSIONS
Repeated courses of betamethasone lead to barely detectable maternal basal cortisol levels and secondary adrenal insufficiency.
McKenna
D S
DS
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Wittber
G M
GM
Nagaraja
H N
HN
Samuels
P
P
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000311:Adrenal Glands / Q000187:drug effects*; D000309:Adrenal Insufficiency / Q000139:chemically induced; D000324:Adrenocorticotropic Hormone; D000328:Adult; D001623:Betamethasone / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007231:Infant, Newborn; D007700:Kinetics; D011247:Pregnancy; D011446:Prospective Studies; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control
D000305:Adrenal Cortex Hormones; D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D001623:Betamethasone; D006854:Hydrocortisone