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Antenatal Glucocorticoid Therapy: Hormone Concentrations

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Part of the book series: Monographs on Endocrinology ((ENDOCRINOLOGY,volume 28))

Abstract

The use of prenatal glucocorticoid therapy for prevention of RDS has provided opportunities to study serum concentrations of administered hormones in both mother and fetus. Data are available from women treated in the third trimester with betamethasone, dexamethasone, and hydrocortisone. The amount of transplacental passage of these corticosteroids and the kinetics of their appearance and disappearance in the fetal circulation are discussed. In addition, I review the effect of glucocorticoid treatment on various endogenous hormones in both mother and fetus.

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References

  • Andersen CW, Cordero L (1980) Changes in amniotic fluid optical density at 450 mil in Rh-sensitized patients after maternal hydrocortisone therapy. Am J Obstet Gynecol 137: 820

    Google Scholar 

  • Andersen GE, Friis-Hansen B (1977) Cord serum and lipoproteincholesterol values in normal and betamethasone-treated newborns of varying gestational age. Acta Paediatr Scand 66: 355

    Article  PubMed  CAS  Google Scholar 

  • Andersen GE, Friis-Hansen B (1978) Hypercholesterolemia in the newborn: Occurrence after antepartum treatment with betamethasone-phenobarbital-ritodrine for the prevention of the respiratory distress syndrome. Pediatrics 62: 8

    PubMed  CAS  Google Scholar 

  • Anderson ABM, Flint APF, Turnbull AC (1975) Mechanism of action of glucocorticoids in induction of ovine parturition: Effect on placental steroid metabolism. J Endocrinol 66: 61

    Article  PubMed  CAS  Google Scholar 

  • Anderson ABM, Gennser G, Jeremy JY, Ohrlander S, Sayers L, Turnbull AC (1977) Placental transfer and metabolism of betamethasone in human pregnancy. Obstet Gynecol 49: 471

    PubMed  CAS  Google Scholar 

  • Anderson GG, Rotchell Y, Kaiser DG (1981) Placental transfer of methylprednisolone following maternal interavenous administration. Am J Obstet Gynecol 140: 699

    PubMed  CAS  Google Scholar 

  • Baden M, Bauer CR, Colle E, Klein G, Taeusch HW Jr, Stern L (1972) A controlled trial of hydrocortisone therapy in infants with respiratory distress syndrome. Pediatrics 50: 526

    PubMed  CAS  Google Scholar 

  • Ballard PL, Granberg P, Ballard RA (1975a) Glucocorticoid levels in maternal and cord serum after prenatal betamethasone therapy to prevent respiratory distress syndrome. J Clin Invest 56: 1548

    Article  PubMed  CAS  Google Scholar 

  • Ballard PL, Carter JP, Graham BS, Baxter JD (1975b) A radioreceptor assay for evaluation of the plasma glucocorticoid activity of natural and synthetic steroids in man. J Clin Endocrinol Metab 41: 290

    Article  PubMed  CAS  Google Scholar 

  • Ballard PL (1979) Delivery and transport of glucocorticoids to target cells. In: Baxter JD, Rousseau GG (eds), Glucocorticoid Hormone Action, Springer, Berlin, Heidelberg, New York, pp 25–48

    Google Scholar 

  • Ballard PL, Gluckman PD, Liggins GC, Kaplan SL, Grumbach MM (1980) Steroid and growth hormone levels in premature infants after prenatal betamethasone therapy to prevent respiratory distress syndrome. Pediatr Res 14: 122

    Article  PubMed  CAS  Google Scholar 

  • Ballard PL, Liggins GC (1982) Glucocorticoid activity in cord serum: Comparison of hydrocortisone and betamethasone regimens. J Pediatr 101: 468

    Article  PubMed  CAS  Google Scholar 

  • Ballard PL, Woeber KA, Klein AH (1982a) Thyroid hormone concentrations in cord serum after placental corticosteroid therapy. Pediatr Res 16: 276A (abstract)

    Google Scholar 

  • Ballard PL, Kitteman JA, Bland RD, Clyman RI, Gluckman PD, Platzker ACG, Kaplan SL, Grumbach MM (1982b) Ontogeny and regulation of corticosteroid binding globulin capacity in plasma of fetal and newborn lambs. Endocrinology 110: 359.

    Article  PubMed  CAS  Google Scholar 

  • Ballard PL, Ballard RA, Gonzales LK, Hümmelink R, Wilson CM, Gross I (1984) Corticosteroid binding by fetal rat and rabbit lung in organ culture. J Steroid Biochem 21: 117

    Article  PubMed  CAS  Google Scholar 

  • Beitins IZ, Bayard F, Ances IG, Kowarski A, Migeon CJ (1972) The transplacental passage of prednisone and prednisolone in pregnancy near term. J Pediatr 81: 936

    Article  PubMed  CAS  Google Scholar 

  • Blanford AT, Murphy BEP (1977) In vitro metabolism of prednisolone, dexamethasone, betamethasone, and cortisol by the human placenta. Am J Obstet Gynecol 127: 264

    PubMed  CAS  Google Scholar 

  • Block MF, Kling R, Crosby WM (1977) Antenatal glucocorticoid therapy for the prevention of respiratory distress syndrome in the premature infant. Obstet Gynecol 50: 186

    PubMed  CAS  Google Scholar 

  • Burr WA, Ramsden DB, Griffiths RS, Black EG, Hoffenberg H, Meinhold H, Wenzel KW (1976) Effect of a single dose of dexamethasone on serum concentrations of thyroid hormones. Lancet II: 58

    Article  Google Scholar 

  • Carson GD, Bolle JD, Challis JRG (1979) The availability of cortisone in amniotic fluid to the fetus and chorionic and amniotic membranes. Endocrinology 104: 1053

    Article  PubMed  CAS  Google Scholar 

  • Charles D, Pinkus JL, Fanous R, Chattoraj SC (1971) The effect of dexamethasone on the urinary excretion of steroids during pregnancy. J Obstet Gynecol Br Comm 78: 241

    Article  CAS  Google Scholar 

  • Collaborative Group on Antenatal Steroid Therapy (1981) Effect of antenatal dexamethasone administration on the prevention of respiratory distress syndrome. Am J Obstet Gynecol 141: 276

    Google Scholar 

  • Duick DS, Warren DW, Nicoloff JT, Otis CL, Croxson MS (1974) Effect of single dose dexamethasone on the concentration of serum triiodothyronine in man. J Clin Endocrinol Metab 39: 1151

    Article  PubMed  CAS  Google Scholar 

  • Elliman D, Browning MCK, Forsyth CC (1981) Adrenal axis suppression due to maternal corticosteroid therapy. Pediatr Res 15: 1187 (abstract)

    Google Scholar 

  • Elsner CW, Buster JE, Preston DL, Killam AP (1979) Interrelationships of circulating maternal steroid concentrations in third trimester pregnancies. III. Effect of intravenous cortisol infusion on maternal concentrations of estriol, 16a-hydroxyprogesterone, 17a-hydroxyprogesterone, progesterone, 20a-dihydroprogesterone, Δ 5-pregnenolone, Δ 5-pregnenolone sulfate, dehydroepiandrosterone sulfate, and cortisol. J Clin Endocrinol Metab 49: 30

    Article  PubMed  CAS  Google Scholar 

  • Flint APF, Goodson JD,Turnbull AC (1975) Increased concentration of 17a-, 20a-hydroxypregn-4-en-3-one in maternal and foetal plasma near parturition in sheep. J Endocrinol 67: 89

    CAS  Google Scholar 

  • Gennser G, Ohrlander S, Eneroth P (1976) Cortisol in amniotic fluid and cord blood in relation to prenatal betamethasone load and delivery. Am J Obstet Gynecol 124: 43

    PubMed  CAS  Google Scholar 

  • Gross I, Ballard PL, Ballard RA, Jones CT, Wilson CM (1983) Corticosteroid stimulation of phosphatidylcholine synthesis in cultured fetal rabbit lung: evidence for de novo protein synthesis mediated by glucocorticoid receptors. Endocrinology 112: 829

    Article  PubMed  CAS  Google Scholar 

  • Huhtaniemi I, Koivisto M, Pakarinen A, Tuimala R, Kauppila A (1982) Pituitary-adrenal and testicular function in preterm infants after prenatal dexamethasone treatment. Acta Paediatr Scand 71: 425

    Article  PubMed  CAS  Google Scholar 

  • Kauppila A, Koivisto M, Pukka M, Tuimala R (1978) Umbilical cord and neonatal cortisol levels: Effect of gestational and neonatal factors. Obstet Gynecol 52: 666

    PubMed  CAS  Google Scholar 

  • Kauppila A, Tuimala R, Ylikorkala O, Reinila M, Ylostalo P (1979) Placental steroid synthesis from DHEAS during dexamethasone therapy. Obstet Gynecol 54: 39

    Article  PubMed  CAS  Google Scholar 

  • Kjer JJ, Hess J (1983) Serum estriol level during treatment with betamethasone in the last trimester of human pregnancy. Acta Obstet Gynecol Scand 62: 307

    Article  PubMed  CAS  Google Scholar 

  • Kream J, Mulay S, Fukushima K, Solomon S (1983) Determination of plasma dexamethasone in the mother and the newborn after administration of the hormone in a clinical trial. J Clin Endocrinol Metab 56: 127

    Article  PubMed  CAS  Google Scholar 

  • Lan NC, Baxter JD (1982) A radioreceptor assay for direct measurement of plasma free glucocorticoid activity. J Clin Endocrinol Metab 55: 516

    Article  PubMed  CAS  Google Scholar 

  • Lefebvre Y, Marier R, Amyot G, Bilodeau R, Hotte R, Raynault P, Durocher JG, Lanthier A (1976) Maternal, fetal, and intra-amniotic hormonal and biologic changes resulting from a single dose of hydrocortisone injected in the intra-amniotic compartment. Am J Obstet Gynecol 125: 609

    PubMed  CAS  Google Scholar 

  • Levitz M, Jansen V, Dancis J (1978) The transfer and metabolism of corticosteroids in the per-fused human placenta. Am J Obstet Gynecol 132: 363

    PubMed  CAS  Google Scholar 

  • Liggins GC, Howie RN (1972) A controlled trial of antepartum glucocorticoid treatment for prevention of the respiratory distress syndrome in premature infants. Pediatrics 50: 515

    PubMed  CAS  Google Scholar 

  • Liggins GC (1974) The influence of the fetal hypothalamus and pituitary on growth. In: Elliott K, Knight J (eds), Size at Birth, Elsevier-Excerpta Medica, North Holland, Amsterdam, pp 165–182

    Google Scholar 

  • Liggins GC (1976) Prenatal glucocorticoid treatment: Prevention of Respiratory Distress Syndrome. In: Moore TD (ed), Proceedings of the 70th Ross Conference on Pediatric Research, Columbus, Ohio, Ross Laboratories

    Google Scholar 

  • Lovinger RD, Kaplan SL, Grumbach MM (1975) Congenital hypopituitarism associated with neonatal hypoglycemia and microphallus: Four cases secondary to hypothalamic hormone deficiencies. J Pediatr 87: 1171

    Article  PubMed  CAS  Google Scholar 

  • Mahajan DK, Anderson G, Poole WK, Billiar RB, Little B (1983) Changes in the concentration of 17a, 20a-dihydroxypregn-4-en-3-one during pregnancy, labor and delivery and the effect of dexamethasone treatment during the third trimester of pregnancy. J Clin Endocrinol Metab 57: 585

    Article  PubMed  CAS  Google Scholar 

  • Maltau JM, Stokke KT, Moe N (1979) Effects of betamethasone on plasma levels of estriol, cortisol and HCS in late pregnancy. Acta Obstet Gynecol Scand 58: 235

    Article  PubMed  CAS  Google Scholar 

  • Meikle AW, Tyler FW (1977) Potency and duration of action of glucocorticoids. Effects of hydrocortisone, prednisone and dexamethasone on human pituitary-adrenal function. Am J Med 63: 200

    Article  PubMed  CAS  Google Scholar 

  • Migeon CJ, Bertrand J, Gemzell CA (1961) The transplacental passage of various steroid hormones in mid-pregnancy. Rec Prog Horm Res 17: 207

    PubMed  CAS  Google Scholar 

  • Morrison JC, Whybrew WD, Bucovaz ET, Schneider JM (1978) Injection of corticosteroids into mother to prevent neonatal respiratory distress syndrome. Am J Obstet Gynecol 131: 358

    PubMed  CAS  Google Scholar 

  • Negulescu RI, Strecker JR, Lauritzen C, Pal S (1977) The influence of betamethasone on the feto-placental unit. A preliminary report. J Perinat Med 5: 120

    Article  PubMed  CAS  Google Scholar 

  • Noguchi A, Reynolds JW (1978) Serum cortisol and dehydroepiandrosterone sulfate responses to adrenocorticotropin stimulation in premature infants. Pediatr Res 12: 1057

    Article  PubMed  CAS  Google Scholar 

  • Ohrlander SAV, Gennser GM, Grennert L (1975) Impact of betamethasone load given to pregnant women on endocrine balance of fetoplacental unit. Am J Obstet Gynecol 123: 228

    PubMed  CAS  Google Scholar 

  • Ohrlander S, Gennser G, Batra S, Lebech P (1976) Effect of betamethasone administration of estrone, estradiol-17ß, and progresterone in maternal plasma and amniotic fluid. Obstet Gynecol 49: 148

    Google Scholar 

  • Ohrlander S, Gennser G, Nilsson KO, Eneroth P (1977) ACTH test to neonates after administration of corticosteroids during gestation. Obstet Gynecol 49: 691

    PubMed  CAS  Google Scholar 

  • Osathanondh R, Tulchinsky D, Kamali H, Fend M deM, Taeusch HW Jr (1977) Dexamethasone levels in treated pregnant women and newborn infants. J Pediatr 90: 617

    Article  PubMed  CAS  Google Scholar 

  • Osathanondh R, Chopra I, Tulchinsky D (1978) Effects of dexamethasone on fetal and maternal thyroxine, triiodothyronine, reverse triiodothyronine, and thyrotropin levels. J Clin Endocrinol Metab 47: 1236

    Article  PubMed  CAS  Google Scholar 

  • Parker CR Jr, Simpson ER, Bilheimer DW, Leveno K, Carr BR, MacDonald PC (1980) Inverse relation between low-density lipoprotein-cholesterol and dehydroisoandrosterone sulfate in human fetal plasma. Science 208: 512

    Article  PubMed  CAS  Google Scholar 

  • Parker CR Jr, Herbert WNP, Morrison JC (1982) The effect of glucocorticoid therapy on fetal cholesterol (C) and adrenal steroids. Soc Gynecol Invest Meeting, page 129 (abstract)

    Google Scholar 

  • Parker CR Jr,Carr BR, Simpson ER, MacDonald PC (1983) Decline in the concentration of lowdensity lipoprotein-cholesterol in human fetal plasma near term. Metabolism 32: 919

    Article  PubMed  CAS  Google Scholar 

  • Peets EA, Staub N, Synchowica C (1969) Plasma binding of betamethasone-3H, dexamethasone-3H and cortisol-14C. A comparative study. Biochem Pharmacol 18: 1655

    Article  PubMed  CAS  Google Scholar 

  • Peterson MC, Nation RL, Ashley JJ, McBride WG (1980) The placental transfer of betamethasone. Eur J Clin Pharmacol 18: 245

    Article  Google Scholar 

  • Reynolds JW, Colle E, Ulstrom RA (1962) Adrenocorticosteroid metabolism in newborn infants. V. Physiologic disposition of exogenous cortisol loads in the early neonatal period. J Clin Endocrinol Metab 22: 245

    Article  PubMed  CAS  Google Scholar 

  • Schatz M, Patterson R, Zeitz S, O’Rourke J, Melan H(1975) Corticosteroid therapy for the pregnant asthmatic patient. J Am Med Assoc 233:804

    Article  CAS  Google Scholar 

  • Schmidt PL, Sims ME, Strassner HT, Paul RH, Mueller E, McCart D (1984) Effect of antepartum glucocorticoid administration upon neonatal respiratory distress syndrome and perinatal infection. Am J Obstet Gynecol 148: 178

    PubMed  CAS  Google Scholar 

  • Simmer HH, Tulchinsky D, Gold EM, Frankland M, Greipel M, Gold AS (1974) On the regulation of estrogen production by cortisol and ACTH in human pregnancy at term. Am J Obstet Gynecol 119: 283

    PubMed  CAS  Google Scholar 

  • Sybulski S (1977) Effect of antepartum betamethasone treatment on cortisol levels in cord plasma, amniotic fluid, and the neonate. Am J Obstet Gynecol 127: 871

    PubMed  CAS  Google Scholar 

  • Tait JF, Burstein S (1964) In vivo studies of steroid dynamics in man. In: Pincus G,Thimann KV (eds), The Hormones, Academic Press, New York, Vol 5, p 441

    Google Scholar 

  • Tauesch HW Jr, Avery ME, Sugg J (1972) Premature delivery without accelerated lung development in fetal lambs treated with longacting methylprednisolone. Biol Neonate 20: 85

    Article  PubMed  CAS  Google Scholar 

  • Teramo K, Hallman M, Raivio KO (1980) Maternal glucocorticoid in unplanned premature labor. Controlled study on the effects of betamethasone phosphate on the phospholipids of the gastric aspirate and on the adrenal cortical function of the newborn infant. Pediatr Res 14: 326

    Article  PubMed  CAS  Google Scholar 

  • Tulchinsky D, Simmer HH (1972) Source of plasma 17a-hydroxyprogesterone in human pregnancy. J Clin Endocrinol Metab 35: 799

    Article  PubMed  CAS  Google Scholar 

  • Tulchinsky D, Okada DM (1975) Hormones in human pregnancy. IV. Plasma progesterone. Am J Obstet Gynecol 121: 293

    PubMed  CAS  Google Scholar 

  • Warrell DW, Taylor R (1968) Otcome for the fetus of mothers receiving prednisolone during pregnancy. Lancet I: 117.

    Article  Google Scholar 

  • Whitt GG, Buster JE, Killam AP, Scragg WH (1976) A comparison of two glucocorticoid regimens for acceleration of fetal lung maturation in premature labor. Am J Obstet Gynecol 124: 479

    PubMed  CAS  Google Scholar 

  • Ylikorkala O, Dawood MY, Kauppila A, Tuimala R (1978) Effect of maternal dexamethasone therapy on the levels of oestrogens, progesterone and chorionic gonadotrophin in amniotic fluid and maternal serum. Br J Obstet Gynaecol 85: 334

    Article  PubMed  CAS  Google Scholar 

  • Zuspan FP, Cordero L, Semchyshyn S (1977) Effects of hydrocortisone on lecithin-spingomyelin ratio. Am J Obstet Gynecol 128: 571

    PubMed  CAS  Google Scholar 

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© 1986 Springer-Verlag Berlin, Heidelberg

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Ballard, P.L. (1986). Antenatal Glucocorticoid Therapy: Hormone Concentrations. In: Hormones and Lung Maturation. Monographs on Endocrinology, vol 28. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-82483-8_6

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  • DOI: https://doi.org/10.1007/978-3-642-82483-8_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-82485-2

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