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Multiple courses of betamethasone to enhance fetal lung maturation do not suppress neonatal adrenal response.

Abstract：

OBJECTIVE:Our purpose was to evaluate the neonatal adrenal gland by provocative testing in neonates of mothers who had received multiple courses of betamethasone to enhance fetal lung maturity. STUDY DESIGN:Infants of mothers who had received >/=3 courses of betamethasone for fetal lung maturation were enrolled in the study. Twenty-four hours after delivery a baseline serum cortisol concentration was obtained. A synthetic adrenocorticotropic hormone (Cortrosyn) was administered (0.25 mg/1.73 m2). Two hours later a second serum cortisol concentration was obtained. An increase in serum cortisol in response to Cortrosyn was considered a positive test result. Nominal data were compared by means of the Student t test. RESULTS:There were 9 infants enrolled in the study. The mean number of betamethasone treatment cycles was 4.8 +/- 1.09. The mean baseline cortisol level was 2.23 +/- 0.52 microgram/dL, and the mean post-adrenocorticotropic hormone cortisol level was 9.86 +/- 1.70 microgram/dL. All neonates had a positive adrenocorticotropic hormone test result. Stepwise linear regression showed no association between the number of courses of betamethasone treatment cycles and the post-adrenocorticotropic hormone cortisol concentration. CONCLUSION:Multiple weekly treatment cycles of betamethasone for fetal lung maturity administered between 24 and 34 weeks' gestation do not appear to cause adrenal suppression.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Terrone DA,Rinehart BK,Rhodes PG,Roberts WE,Miller RC,Martin JN Jr

doi

10.1016/s0002-9378(99)70018-9

subject

Has Abstract

pub_date

1999-06-01 00:00:00

pages

1349-53

issue

6 Pt 1

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(99)70018-9

journal_volume

180

pub_type

杂志文章

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