A comparative study of cardiovascular, endocrine and behavioural effects of betamethasone and dexamethasone administration to fetal sheep.

Derks, Jan; Giussani, Dino A.; Jenkins, Susan L.; Wentworth, Richard A.; Visser, Gerard H.A.; Padbury, Jamés F.; Nathanielsz, Peter W.

doi:10.1113/jphysiol.1997.sp021922

Cited by 161 publications

(149 citation statements)

References 29 publications

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“…In previous studies, high doses of glucocorticoids administered for a short time to the fetal sheep increase blood pressure to a similar extent to that seen in this study, with no change in heart rate (Hill et al 1988, Derks et al 1997. In addition, it has been reported that dexamethasone treatment to pregnant rats during the last third of gestation produces elevated blood pressure in the offspring (Levitt et al 1996).…”

Section: Blood Pressuresupporting

confidence: 47%

The effect of a chronic maternal cortisol infusion on the late-gestation fetal sheep

Jensen¹,

Gallaher²,

Breier³

et al. 2002

Journal of Endocrinology

114

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Exposure of the fetus to excess maternal glucocorticoids has been postulated to alter fetal growth and development, and thus provide a possible mechanism for the link between impaired fetal growth and altered postnatal physiology. However, the effects of exposure to excess maternal glucocorticoids on fetal physiology and metabolism in utero have not been described. We therefore studied the effects of chronic maternal cortisol infusion on fetal growth, blood pressure, metabolism and endocrine status in chronically catheterised fetal sheep. We infused hydrocortisone (80 mg/day, n=6) or saline (n=8) for 10 days into the pregnant ewes beginning at 119 days of gestation. Maternal cortisol infusion reduced fetal growth rate by 30% (girth increment 2·9 0·3 vs 1·8 0·4 mm/ day, P=0·03). Maternal cortisol infusion increased fetal heart weight by 15% relative to body weight and increased ventricular wall thickness by 30% in the left and 50% in the right ventricle. The weight of the spleen was reduced by 30% and placental weight reduced by 25%. Fetal blood pressure increased by approximately 10 mmHg (20%) during maternal cortisol infusion.Maternal cortisol infusion did not alter amino-nitrogen concentrations. However, maternal lactate concentrations increased by 80% and fetal lactate concentrations increased by 74% with maternal cortisol infusion, and both maternal and fetal urea concentrations increased by 40%. Circulating maternal IGF-binding protein (IGFBP)-3 levels had increased by 20% by the end of the maternal cortisol infusion. Fetal IGF-I concentrations decreased during cortisol infusion and fetal IGFBP-1 concentrations were negatively correlated with fetal weight (r= 0·76, P=0·02).We conclude that even a modest elevation of maternal cortisol levels affects fetal growth, cardiovascular function, metabolism and endocrine status which may have longterm consequences.

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Section: Blood Pressuresupporting

confidence: 47%

The effect of a chronic maternal cortisol infusion on the late-gestation fetal sheep

Jensen¹,

Gallaher²,

Breier³

et al. 2002

Journal of Endocrinology

114

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“…Adrenergic cardiovascular drive and noradrenergic infl uences play a key role in the development or progression of hypertension and the metabolic syndrome in the adult (Grassi et al, 2009), making this system another key candidate for glucocorticoid induced long-term alterations in system balance. This notion is supported by experiments showing a sustained elevation of blood pressure and altered baroreceptor heart rate response in fetal sheep and the baboon and increased central and peripheral vascular resistance after glucocorticoid administration (Derks et al, 1997;Fletcher et al, 2002;Koenen et al, 2002;Schwab et al, 2000). 6.5 HPA axis functionality in neonates after intrauterine betamethasone treatment Η 53…”

Section: Vulnerability Of the Sympathetic Nervous Systemsupporting

confidence: 59%

6 Intrauterine corticosteroids for lung maturation: Observations of HPA axis function and cardiac autonomic balance in the neonate

Schäffer¹,

Burkhardt²,

Tomaske³

et al. 2011

Perinatal Programming

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“…the age at which most fetuses were monitored in the present study. In addition, no changes were found in limb movements and nuchal muscle activity after betamethasone infusion into the fetal sheep (19). So, whether or not the increases in ACC are due to increased fetal bodily activity awaits further direct ultrasound observation.…”

mentioning

confidence: 99%

“…The decrease in FHR generally occurred within one to several hours after the start of corticosteroid administration, indicative of involvement of nongenomic glucocorticoid receptors (GR), and was associated with an increase in arterial blood pressure (17)(18)(19)(20)(21). The latter is a known effect of corticosteroids and is assumed to result from increased peripheral vascular resistance (22,23).…”

mentioning

confidence: 99%

Short-Term (0–48 h) Effects of Maternal Betamethasone Administration on Fetal Heart Rate and Its Variability

et al. 2005

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The short-term (0 -48 h) effects of maternal betamethasone administration on computerized fetal heart rate (FHR) parameters were studied in 36 pregnancies at increased risk for preterm delivery. FHR was recorded for 90 min immediately before the start of betamethasone treatment and again at 6-h intervals during the next 48 h. Multiple linear regression models were used to assess the possible effects on FHR parameters of gestational age, time of day, clinical indication for treatment, and use of tocolytic drugs. Within 12 h after the start of treatment, significant increases occurred in FHR accelerations, and short-and long-term FHR variability (36%, 28%, and 22%, respectively), whereas basal FHR showed a 5% decrease. FHR variability was decreased by 10% at 42-48 h. The observed changes were more pronounced in older (29 -33 wk of gestation) compared with younger fetuses (25-28 wk of gestation). Decelerations occurred only in 4 out of 11 compromised fetuses during betamethasone therapy. We conclude that there are significant changes in FHR parameters during the first 48 h after betamethasone administration. These changes are transient in normal fetuses. However, the compromised fetus may be adversely affected by betamethasone. Abbreviations ACC, number of fetal heart rate accelerations FHR, fetal heart rate LTV, long-term variability STV, short-term variability Antenatal corticosteroid administration to pregnant women with threatened preterm delivery has proven to successfully reduce the risk of sequelae of prematurity, such as the respiratory distress syndrome (1,2). Recent findings in the fetus and neonate have focused attention on a variety of extrapulmonary effects of corticosteroids, including side effects on metabolic, endocrine, immunologic, cardiovascular, and CNS function (3-10). Maternal betamethasone administration has been described to transiently reduce fetal movements and heart rate variability, which are commonly used as indicators of the fetal condition (5-10). The reductions were most profound 48 -72 h after the first of two injections of betamethasone (doses 24 h apart) in studies that comprised 1-h recordings made on each of five successive days.Betamethasone readily crosses the placenta and fetal levels keep pace with the rapidly increasing maternal levels during the first few hours after administration of this drug (11). It may, therefore, be anticipated that betamethasone already exerts an effect on the fetus shortly after injection to the mother. However, the few studies that have reported on early effects of betamethasone showed an increase in FHR variability, an increase or decrease in basal FHR, or no change at all in either parameter when data were obtained within 24 h postinjection (5,6,8,10).The present study was designed to study the temporal effect of maternal betamethasone administration on various FHR parameters at 6-h intervals during the first 48 h after the initiation of treatment. We took into account the possible influences of the time of day at which betamethasone was adminis...

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A comparative study of cardiovascular, endocrine and behavioural effects of betamethasone and dexamethasone administration to fetal sheep.

Cited by 161 publications

References 29 publications

The effect of a chronic maternal cortisol infusion on the late-gestation fetal sheep

The effect of a chronic maternal cortisol infusion on the late-gestation fetal sheep

6 Intrauterine corticosteroids for lung maturation: Observations of HPA axis function and cardiac autonomic balance in the neonate

Short-Term (0–48 h) Effects of Maternal Betamethasone Administration on Fetal Heart Rate and Its Variability

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