title: Effects of antenatal glucocorticoid therapy on hippocampal histology of preterm infants.
abstract: OBJECTIVE
  To investigate if antenatal glucocorticoid treatment has an effect on hippocampal histology of the human preterm newborn.
  
  
  METHODS
  Included were consecutive neonates with a gestational age between 24 and 32 weeks, who were born between 1991 to 2009, who had died within 4 days after delivery and underwent brain autopsy. Excluded were neonates with congenital malformations and neonates treated postnatally with glucocorticoids. The brains were routinely fixed, samples of the hippocampus were stained with haematoxylin and eosin and sections were examined for presence or absence of large and small neurons in regions of the hippocampus. Additional staining with GFAP, neurofilament and vimentin was performed to evaluate gliosis and myelination. The proliferation marker Ki67 was used to evaluate neuronal proliferation. Staining with acid fuchsin-thionin was performed to evaluate ischemic damage.
  
  
  RESULTS
  The hippocampi of ten neonates who had been treated with antenatal glucocorticoids showed a lower density of large neurons (p = 0.01) and neurons irrespective of size (p = 0.02) as compared to eleven neonates who had not been treated with glucocorticoids. No difference was found in density of small neurons, in myelination, gliosis, proliferation or ischemic damage.
  
  
  CONCLUSIONS
  We found a significantly lower density of neurons in the hippocampus of neonates after antenatal glucocorticoid treatment. Although the pathophysiological and clinical interpretations of these findings are not clear, they are consistent with those from experiments in mice and rhesus monkeys.
authors.affiliation: Perinatal Center, University Medical Center, Utrecht, The Netherlands. d.tijsseling-2@umcutrecht.nl
authors.forename: Deodata
authors.initials: D
authors.lastname: Tijsseling
authors.forename: Lia D E
authors.initials: LD
authors.lastname: Wijnberger
authors.forename: Jan B
authors.initials: JB
authors.lastname: Derks
authors.forename: Cindy T J
authors.initials: CT
authors.lastname: van Velthoven
authors.forename: Willem B
authors.initials: WB
authors.lastname: de Vries
authors.forename: Frank
authors.initials: F
authors.lastname: van Bel
authors.forename: Peter G J
authors.initials: PG
authors.lastname: Nikkels
authors.forename: Gerard H A
authors.initials: GH
authors.lastname: Visser
mesh_terms: D005904:Glial Fibrillary Acidic Protein / Q000378:metabolism; D005938:Glucocorticoids / Q000494:pharmacology / Q000627:therapeutic use*; D006624:Hippocampus / Q000033:anatomy & histology / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D016900:Neurofilament Proteins / Q000378:metabolism; D009474:Neurons / Q000378:metabolism; D014746:Vimentin / Q000378:metabolism
chemical_list: D005904:Glial Fibrillary Acidic Protein; D005938:Glucocorticoids; D016900:Neurofilament Proteins; D014746:Vimentin