Antenatal glucocorticoid treatment affects preterm infants' S100B urine concentration in a dose-dependent manner.
BACKGROUND
Maternal glucocorticoid (GC) treatment is widely used to prevent lung immaturity in preterm infants. There is growing evidence that GCs may be detrimental to the Central Nervous System (CNS). We investigated whether antenatal GC administration affects CNS function in a dose-dependent manner by measuring urine concentrations of a well-established brain damage marker, S100B.


METHODS
We conducted a case-control-study in 70 preterm infants (1 GC vs 1 control) whose mothers received a complete GC-course (GC2, n=16), half-course (GC1, n=19), and controls (n=35). At four predetermined time-points, in the first 72 h from birth, we assessed S100B urine concentrations, using a commercially available immunoluminometric assay (Lia-mat Sangtec 100, AB Sangtec Medical, Bromma, Sweden). Data were correlated with primary neonatal outcomes (incidence of respiratory distress syndrome, length of ventilatory support and hospital stay, incidence of intraventricular hemorrhage, adverse 7th day neurological follow-up and neonatal death).


RESULTS
S100B in GC2 group at all monitoring time-points was significantly lower (P<0.01) than controls and GC1 group, while no differences (P>0.05) were evident between controls and GC1 group. No significant differences (P>0.05) were shown in primary outcomes between half or complete GC-course treated groups.


CONCLUSIONS
S100B levels of infants antenatally treated with GCs differed in a dose-dependent manner. Data on primary outcomes suggest that lowering antenatal GC-course may be less detrimental for brain without affecting lung maturation. Further clinical trials are needed to elucidate the low GC-course issue.
Sannia
Andrea
A
Dept. of Neonatology Obstetrics and Neuroscience, G Gaslini Children's University Hospital, Genoa, Italy.
Risso
Francesco M
FM
Serpero
Laura D
LD
Frulio
Rosanna
R
Michetti
Fabrizio
F
Abella
Raul
R
Frigiola
Alessandro
A
Giamberti
Alessandro
A
Gazzolo
Diego
D
D000328:Adult; D015415:Biomarkers / Q000652:urine; D016022:Case-Control Studies; D002490:Central Nervous System / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000139:chemically induced*; D008168:Lung / Q000187:drug effects / Q000254:growth & development; D009414:Nerve Growth Factors / Q000652:urine*; D011247:Pregnancy; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000652:urine*
D015415:Biomarkers; D005938:Glucocorticoids; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; C579160:S100B protein, human