Intra-amniotic corticosteroids for preterm lung maturation in sheep.
OBJECTIVE
The purpose of this study was to compare efficacy on fetal lung maturation of intra-amniotic betamethasone or budesonide with the efficacy of maternal intramuscular betamethasone.


METHODS
Pregnant ewes received intra-amniotic betamethasone (0.5 mg/kg or 2 mg/kg fetal weight), intra-amniotic budesonide (0.5 mg/kg or 2 mg/kg), maternal intramuscular betamethasone (0.5 mg/kg maternal weight), intra-amniotic saline solution, or maternal saline solution. Lambs were delivered 2 or 7 days later, at 124 days of gestation for measurement of respiratory system compliance, ventilatory efficiency index, and surfactant levels.


RESULTS
Lung function increased 2 days after maternal betamethasone, intra-amniotic betamethasone (2 mg/kg), and intra-amniotic budesonide (2 mg/kg) administration and 7 days after maternal betamethasone or intra-amniotic budesonide (2.0 mg/kg) administration. Lung function was not improved 7 days after intra-amniotic betamethasone (2.0 mg/kg) administration or 2 days after intra-amniotic betamethasone (0.5 mg/kg) or intra-amniotic budesonide (0.5 mg/kg) administration. Intra-amniotic corticosteroid administration increased fetal death and respiratory morbidity.


CONCLUSIONS
Intra-amniotic corticosteroid administration improved preterm lung function, but the associated morbidity and mortality rates suggest that they are not suitable for clinical use.
Moss
Timothy J m
TJ
Lotteries Commission Perinatal Research Laboratories, School of Women's and Infants' Health, University of Western Australia, Box M094, 35 Stirling Highway, Crawley, Perth, WA 6009, Australia. tmoss@cyllene.uwa.edu.au
Mulrooney
Neil P
NP
Nitsos
Ilias
I
Ikegami
Machiko
M
Jobe
Alan H
AH
Newnham
John P
JP
D000650:Amnion; D000818:Animals; D000831:Animals, Newborn / Q000502:physiology; D001623:Betamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D019819:Budesonide / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005313:Fetal Death; D005325:Fetal Organ Maturity; D005333:Fetus; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D015994:Incidence; D007273:Injections, Intramuscular; D008168:Lung / Q000187:drug effects / Q000196:embryology* / Q000502:physiology; D055370:Lung Injury; D009035:Mothers; D011247:Pregnancy; D011656:Pulmonary Emphysema / Q000139:chemically induced / Q000453:epidemiology; D011663:Pulmonary Surfactants / Q000378:metabolism; D012140:Respiratory Tract Diseases / Q000139:chemically induced; D012421:Rupture / Q000139:chemically induced / Q000453:epidemiology; D012756:Sheep; D016896:Treatment Outcome
D005938:Glucocorticoids; D011663:Pulmonary Surfactants; D019819:Budesonide; D001623:Betamethasone