Schäffer Leonhard, Luzi Franziska, Burkhardt Tilo, Rauh Manfred, Beinder Ernst
From the Department of Obstetrics and Gynecology, University of Zuürich, Zuürich, Switzerland; and the Department of Pediatrics, University of Erlangen, Erlangen, Germany.
Obstet Gynecol. 2009 May;113(5):1082-1088. doi: 10.1097/AOG.0b013e3181a1f0e6.
To analyze hypothalamic-pituitary-adrenal axis balance in healthy newborns after antenatal betamethasone treatment for lung maturation where delivery could be prolonged until or near term.
In a prospective observational study, salivary cortisol and cortisone levels were measured at the fourth day of life during resting conditions and in response to a pain-induced stress event in 23 neonates with antenatal exposure to a single course of betamethasone (2x12 mg) and compared with 40 controls. The mean interval between betamethasone treatment and delivery was 60+/-23 days.
On day 4 of life, neonates in the control group exhibited a significant increase in cortisol and cortisone from baseline levels after the stress induction (1.175-2.4 ng/mL for cortisol and 11.35-18.15 ng/mL for cortisone [both P<.05]), whereas, in betamethasone-exposed neonates, cortisol and cortisone stress response was not significantly different from baseline levels (1.39-1.6 ng/mL for cortisone [P=.76] and 14.8-17.1 ng/mL for cortisol [P=.69]). No influence of gestational age at betamethasone administration (P=.76) or gestational age at delivery (P=.71) on stress response patterns was observed in a multiple stepwise regression.
A single course of antenatal betamethasone treatment induces a suppression of stress reactivity in healthy newborns.
分析产前接受倍他米松治疗以促进肺成熟且分娩可延长至足月或接近足月的健康新生儿的下丘脑 - 垂体 - 肾上腺轴平衡。
在一项前瞻性观察研究中，对23例产前接受单疗程倍他米松（2×12毫克）治疗的新生儿及40例对照组新生儿在出生后第4天静息状态下以及对疼痛诱发的应激事件反应时测量唾液皮质醇和可的松水平。倍他米松治疗与分娩之间的平均间隔为60±23天。
出生后第4天，对照组新生儿在应激诱导后皮质醇和可的松水平较基线显著升高（皮质醇为1.175 - 2.4纳克/毫升，可的松为11.35 - 18.15纳克/毫升[均P<0.05]），而在接受倍他米松治疗的新生儿中，皮质醇和可的松应激反应与基线水平无显著差异（可的松为1.39 - 1.6纳克/毫升[P = 0.76]，皮质醇为14.8 - 17.1纳克/毫升[P = 0.69]）。在多元逐步回归中未观察到倍他米松给药时的胎龄（P = 0.76）或分娩时的胎龄（P = 0.71）对应激反应模式有影响。
单疗程产前倍他米松治疗可抑制健康新生儿的应激反应性。
