Effect of Single and Multiple Courses of Prenatal Corticosteroids on 17-Hydroxyprogesterone Levels: Implication for Neonatal Screening of Congenital Adrenal Hyperplasia

Gatelais, Frédérique; Berthelot, Jacques; Beringue, F; Descamps, Philippe; Bonneau, Dominique; Limal, Jean-Marie; Coutant, Régis

doi:10.1203/01.pdr.0000142733.50918.6e

Cited by 47 publications

(32 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conversely, antenatal corticosteroid administration can interfere with CAH screening programs, because corticosteroids are known to suppress the HPA axis55,56). Since betamethasone and dexamethasone are similar in their ability to cross the placenta and suppress the fetal pituitary-adrenal axis, the use of antenatal corticosteroids may increase the risk of lowering 17-OHP levels in the blood spot, thus leading to false-negative results.…”

Section: Adrenal Gland Of Preterm Infantsmentioning

confidence: 99%

Adrenal and thyroid function in the fetus and preterm infant

Chung

2014

Korean J Pediatr

View full text Add to dashboard Cite

Adrenal and thyroid hormones are essential for the regulation of intrauterine homeostasis, and for the timely differentiation and maturation of fetal organs. These hormones play complex roles during fetal life, and are believed to underlie the cellular communication that coordinates maternal-fetal interactions. They serve to modulate the functional adaptation for extrauterine life during the perinatal period. The pathophysiology of systemic vasopressor-resistant hypotension is associated with low levels of circulating cortisol, a result of immaturity of hypothalamic-pituitary-adrenal axis in preterm infants under stress. Over the past few decades, studies in preterm infants have shown abnormal clinical findings that suggest adrenal or thyroid dysfunction, yet the criteria used to diagnose adrenal insufficiency in preterm infants continue to be arbitrary. In addition, although hypothyroidism is frequently observed in extremely low gestational age infants, the benefits of thyroid hormone replacement therapy remain controversial. Screening methods for congenital hypothyroidism or congenital adrenal hyperplasia in the preterm neonate are inconclusive. Thus, further understanding of fetal and perinatal adrenal and thyroid function will provide an insight into the management of adrenal and thyroid function in the preterm infant.

show abstract

Section: Adrenal Gland Of Preterm Infantsmentioning

confidence: 99%

Adrenal and thyroid function in the fetus and preterm infant

Chung

2014

Korean J Pediatr

View full text Add to dashboard Cite

show abstract

“…Short-and long-term glucocorticoid treatment in pregnancy has been shown to decrease fetal and maternal adrenal androgens, but it moderately decreases 17OHP and E2 by only 30% (35)(36)(37)(38). Thus, possibly as much as 70% of 17OHP, androgens, and estrogens in the maternal compartment are from a placental source.…”

Section: Antenatal Corticosteroidsmentioning

confidence: 99%

The Human Placenta Expresses CYP17 and Generates AndrogensDe Novo

Escobar

Patel

Beshay

et al. 2011

The Journal of Clinical Endocrinology & Metabolism

View full text Add to dashboard Cite

show abstract

“…However, the confidence interval for the no-ANS group was wide, as only 3 mothers had received no ANS. In previous studies, the effect of maternal ANS on adrenal steroid levels in the newborns has been conflicting: some have found that steroid levels are lower in the infants, whose mothers have received ANS [12,27] and others have found no difference [28]. In this study, the number of ANS courses to the mothers did not differ between the gestational age groups <28 and ≥28 weeks, and adjusting the mixed model analyses with the number of ANS courses did not change the observed differences in steroid levels between these gestational age groups.…”

Section: Discussionmentioning

confidence: 99%

Serum Concentrations of Adrenal Steroids and Their Precursors as a Measure of Maturity of Adrenocortical Function in Very Premature Newborns

et al. 2010

View full text Add to dashboard Cite

Background: Relative adrenocortical insufficiency is often seen in sick premature newborns. As the human fetal adrenal cortex does not express the 3β-hydroxysteroid dehydrogenase (3β-HSD) enzyme before about 23 weeks of gestation, we hypothesized that this enzymatic step may be rate limiting in cortisol synthesis in premature infants of less than 28 weeks postmenstrual age at birth. Methods: We measured cord, first day (D0) and median fourth day (D4) serum 17-OH-pregnenolone (17-OHPreg), 17-OH-progesterone (17-OHProg), 11-deoxycortisol, cortisol (F) and dehydroepiandrosterone sulphate concentrations and calculated the substrate/product ratios in 67 infants with gestational age 23.6–33.1 weeks. Results: The mean 17-OHPreg/17-OHProg ratio as a marker of 3β-HSD activity did not differ between the gestational age groups (gestational age <28 vs. ≧28 weeks: 0.40 vs. 0.48, p = 0.52 for cord, 3.1 vs. 2.4, p = 0.25 for D0, and 1.6 vs. 1.9, p = 0.62 for D4). In addition, the 17-OHPreg/17-OHProg ratio did not differ between the infants in the lowest F tertile compared to those in the highest F tertile group, and the serum 17-OHPreg and 17-OHProg concentrations were parallel with the respective F concentrations. Conclusion: We did not find evidence of significant immaturity in adrenal 3β-HSD activity in preterm infants between 24 and 28 weeks of gestation.

show abstract

Effect of Single and Multiple Courses of Prenatal Corticosteroids on 17-Hydroxyprogesterone Levels: Implication for Neonatal Screening of Congenital Adrenal Hyperplasia

Cited by 47 publications

References 37 publications

Adrenal and thyroid function in the fetus and preterm infant

Adrenal and thyroid function in the fetus and preterm infant

The Human Placenta Expresses CYP17 and Generates AndrogensDe Novo

Serum Concentrations of Adrenal Steroids and Their Precursors as a Measure of Maturity of Adrenocortical Function in Very Premature Newborns

Contact Info

Product

Resources

About