Antenatal betamethasone administration alters stress physiology in healthy neonates.
OBJECTIVE
To analyze hypothalamic-pituitary-adrenal axis balance in healthy newborns after antenatal betamethasone treatment for lung maturation where delivery could be prolonged until or near term.


METHODS
In a prospective observational study, salivary cortisol and cortisone levels were measured at the fourth day of life during resting conditions and in response to a pain-induced stress event in 23 neonates with antenatal exposure to a single course of betamethasone (2x12 mg) and compared with 40 controls. The mean interval between betamethasone treatment and delivery was 60+/-23 days.


RESULTS
On day 4 of life, neonates in the control group exhibited a significant increase in cortisol and cortisone from baseline levels after the stress induction (1.175-2.4 ng/mL for cortisol and 11.35-18.15 ng/mL for cortisone [both P<.05]), whereas, in betamethasone-exposed neonates, cortisol and cortisone stress response was not significantly different from baseline levels (1.39-1.6 ng/mL for cortisone [P=.76] and 14.8-17.1 ng/mL for cortisol [P=.69]). No influence of gestational age at betamethasone administration (P=.76) or gestational age at delivery (P=.71) on stress response patterns was observed in a multiple stepwise regression.


CONCLUSIONS
A single course of antenatal betamethasone treatment induces a suppression of stress reactivity in healthy newborns.
Schäffer
Leonhard
L
From the Department of Obstetrics and Gynecology, University of Zuürich, Zuürich, Switzerland; and the Department of Pediatrics, University of Erlangen, Erlangen, Germany.
Luzi
Franziska
F
Burkhardt
Tilo
T
Rauh
Manfred
M
Beinder
Ernst
E
D001623:Betamethasone / Q000008:administration & dosage*; D016022:Case-Control Studies; D003348:Cortisone / Q000378:metabolism; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D010913:Pituitary-Adrenal System / Q000187:drug effects; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000378:metabolism / Q000503:physiopathology*; D013312:Stress, Physiological / Q000187:drug effects* / Q000502:physiology
D005938:Glucocorticoids; D001623:Betamethasone; D003348:Cortisone; D006854:Hydrocortisone