Repeat doses of antenatal steroids and hypothalamic-pituitary-adrenal axis (HPA) function.
OBJECTIVE
This study was undertaken to compare the effects of exposure to repeated courses of antenatal steroids with those of a single course on hypothalamic-pituitary-adrenal axis function.


METHODS
Women at risk of premature delivery were assessed for entry into a randomized controlled trial of repeated courses of corticosteroids (ACTORDS). If a woman declined the randomized trial then consent was sought for collection of observational data. Baseline bloods for cortisol and adrenocorticotropic hormone levels were collected and in a subset of infants a metyrapone test performed.


RESULTS
In the 86 studied infants, cortisol and adrenocorticotropic hormone levels did not differ between those exposed to single and repeated courses of antenatal steroids (P = .53 and P = .15, respectively). Although cortisol levels fell in response to metyrapone (P = .03) this response was not different between the single and repeated course groups (P = .46).


CONCLUSIONS
Repeated courses of antenatal steroids do not cause important hypothalamic-pituitary-adrenal axis suppression in the neonate.
Battin
Malcolm R
MR
Department of Paediatrics, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Bevan
Coila
C
Harding
Jane E
JE
D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D001724:Birth Weight; D004311:Double-Blind Method; D005260:Female; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects*; D007231:Infant, Newborn; D007752:Obstetric Labor, Premature / Q000188:drug therapy; D010913:Pituitary-Adrenal System / Q000187:drug effects*; D011247:Pregnancy; D016896:Treatment Outcome
D005938:Glucocorticoids; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone