Neonatal adrenal function after repeat dose prenatal corticosteroids: A randomized controlled trial - 18/08/11
, Kristyn J. Willson, BSc (Hons) b, Ross R. Haslam, FRACP c, David J. Kennaway, PhD a, Janet E. Hiller, PhD b, Jeffrey S. Robinson, FRANZCOG a
Reprint requests: Caroline Crowther, FRANZCOG, Department of Obstetrics and Gynaecology, The University of Adelaide, Women’s and Children’s Hospital, 72 King William Rd, North Adelaide SA 5006 Australia.Abstract |
Objective |
Do repeat prenatal corticosteroids suppress neonatal cortisol concentrations?
Study design |
Randomized controlled trial of women given weekly repeat corticosteroids or saline placebo, while at risk of preterm birth, until 32 weeks’ gestation.
Results |
Cord serum cortisol concentrations in infants exposed to repeat corticosteroids were similar compared with infants exposed to a single course of corticosteroids (mean difference −26 nmol/L (95% CI −57, 5 nmol/L, P = .10), as were prestress salivary cortisol concentrations on day 3 (median 16.5 vs 15.3 nmol/L, P = .96). The adrenal response to a stressor on day 3 was lower in the repeat corticosteroid group compared with the single course group (median 11.9 vs 21.4 nmol/L, P = .02). Cortisol concentrations were lower in the repeat corticosteroid group on day 7 (median 11.7 vs 18.2 nmol/L, P = .04), but not on days 14 and 21.
Conclusion |
The short- or long-term clinical impact, if any, of these changes in adrenal function needs to be determined.
Le texte complet de cet article est disponible en PDF.Key words : Repeat corticosteroids, Neonatal adrenal suppression, Randomized trial
Plan
| Support provided by Channel 7 Children’s Research Foundation, South Australia. |
Vol 194 - N° 3
P. 861-867 - mars 2006 Retour au numéro
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