Effect of antenatal betamethasone administration on neonatal cardiac autonomic balance.
Beneficial effects of antenatal glucocorticoid treatment in pregnancies at risk for preterm delivery may entail long-term consequences for the establishment of sympathoadrenergic system balance. We analyzed the cardiac autonomic system activity in neonates with a single course of antenatal betamethasone (2 × 12 mg) treatment by calculating heart rate variability (HRV) time-domain parameters from 24 h ECG recordings and short-term frequency-domain parameters during infant active and resting states. In addition, resting and challenged salivary α-amylase levels were measured in 23 betamethasone-exposed neonates and compared with controls. Indicators for overall HRV (SDNN: p = 0.258; triangular index: p = 0.179) and sympathovagal balance [low- to high-frequency power (LF/HF): p = 0.82 (resting state)] were not significantly different in neonates of the betamethasone treatment group. Parameters mostly influenced by sympathetic activity [SD of the average of valid NN intervals (SDANN): p = 0.184 and SDs of all NN intervals (SDNNi): p = 0.784] and vagal tone [RMSSD: p = 1.0; NN50: p = 0.852; HF: p = 0.785 (resting state)] were unaltered. Resting α-amylase levels were not significantly different in the betamethasone treatment group (p = 0.304); however, α-amylase release after a neonatal challenge was slightly reduced (p = 0.045). Thus, cardiac autonomic balance seems to be preserved in neonates exposed to a single course of antenatal betamethasone treatment.
Schäffer
Leonhard
L
Department of Obstetrics and Gynecology, University Hospital of Zürich, Zürich 8091, Switzerland. leonhard.schaeffer@usz.ch
Burkhardt
Tilo
T
Tomaske
Maren
M
Schmidt
Sina
S
Luzi
Franziska
F
Rauh
Manfred
M
Leone
Antonio
A
Beinder
Ernst
E
D001341:Autonomic Nervous System / Q000187:drug effects*; D001623:Betamethasone / Q000008:administration & dosage* / Q000009:adverse effects; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005260:Female; D005325:Fetal Organ Maturity / Q000187:drug effects*; D005865:Gestational Age; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006321:Heart / Q000294:innervation*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000187:drug effects / Q000196:embryology; D008297:Male; D047928:Premature Birth; D012463:Saliva / Q000201:enzymology; D013557:Switzerland; D013997:Time Factors; D000516:alpha-Amylases / Q000378:metabolism
D005938:Glucocorticoids; D001623:Betamethasone; D000516:alpha-Amylases