The effect of a single course of antenatal corticosteroids on maternal adrenal function at term.
OBJECTIVE
To determine if one course of antenatal corticosteroids at 32 weeks produces maternal adrenal suppression at term.


METHODS
The adrenocorticotropic hormone (ACTH) stimulation test was administered at 38 weeks to 11 pregnant women who had received a single course of antenatal betamethasone prior to 33 weeks and to six control subjects.


RESULTS
There was no difference in basal cortisol levels (mean+/-standard deviation) between the two groups: 41.6+/-6.9 microg/dl for controls versus 36.0+/-7.8 microg/dl for the steroid group, p=0.16. Peak cortisol levels at 45 min following ACTH stimulation were not different: 61.6+/-3.5 microg/dl for controls versus 55.0+/-2.6 microg/dl for the steroid group, p=0.16. The power of the study to detect a statistical difference in the observed peak cortisol levels was greater than 95%. None of the study subjects had laboratory criteria or clinical signs of adrenal suppression.


CONCLUSIONS
A single course of betamethasone for women at risk for preterm delivery does not produce adrenal insufficiency at term and stress dose steroids are not recommended.
McKenna
D S
DS
US Air Force Medical Corp, Wright State University, Department of Obstetrics and Gynecology, Wright-Patterson Air Force Base, OH 45433, USA.
Fisk
A D
AD
D000304:Adrenal Cortex Function Tests; D000311:Adrenal Glands / Q000187:drug effects*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001623:Betamethasone / Q000008:administration & dosage*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D000324:Adrenocorticotropic Hormone; D001623:Betamethasone