Transient catabolic state with reduced IGF-I after antenatal glucocorticoids.
TL;DR: An antenatal course of GC elicited a transient catabolic state encompassing all nutrient substrates, and a temporary drop in IGF-I concentrations, which may explain the growth-inhibitory effects of repeated antenatal GC administration.
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Abstract: Glucocorticoid (GC) administration before preterm birth reduces neonatal morbidity but may restrain growth. Here we explored the effect of antenatal GC on nutrient substrates (glucose, FFA, amino acids (AA)), and on IGF-I and IGF-binding protein-1 (IGFBP-1). We analyzed umbilical vein (UV) plasma obtained at birth from 91 preterm newborns that received one course of GC (last exposure 1-1358 h before birth) and 49 newborns that did not. We found that recent GC exposure (48 h) raised glucose, FFA, and AA concentrations, and the homeostasis model assessment of insulin resistance (HOMA-IR) index, but lowered IGF-I concentrations. The AA surge was greater in newborns with a birth weight z score 0 than in those with a z score 0. Although all AA were transiently increased, the increment was most robust for glutamine and alanine. Shorter duration since GC administration and lower IGF-I concen- trations independently predicted AA levels. In conclusion, an ante- natal course of GC elicited a transient catabolic state encompassing all nutrient substrates, and a temporary drop in IGF-I concentrations. These changes may explain the growth-inhibitory effects of repeated antenatal GC administration. Future research should clarify the role of IGF-I in the protein-catabolic response to GC. (Pediatr Res 62: 295-300, 2007)
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Citations
Should we be prescribing repeated courses of antenatal corticosteroids
John P. Newnham,Alan H. Jobe +1 more
TL;DR: In view of the well-established role that corticosteroids are known to play in brain development, and the marginal difference that repeated courses may make to outcome in the context of modern neonatal care, antenatal Corticosteroid treatments should be restricted to single-course treatment.
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TL;DR: Current evidence for the short- and long-term health effects of antenatal glucocorticoid therapy is reviewed and the apparent discrepancy between data from randomized clinical trials and other studies is discussed.
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Antenatal glucocorticoids reduce growth in appropriately grown and growth-restricted ovine fetuses in a sex-specific manner
Suzanne L. Miller,Amy E. Sutherland,Veena Supramaniam,David W. Walker,David W. Walker,Graham Jenkin,Graham Jenkin,Euan M. Wallace,Euan M. Wallace +8 more
TL;DR: It is suggested that antenatal glucocorticoids reduce fetal growth in a sex-specific manner, with females more growth restricted than males.
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Metabolic and hormonal effects of antenatal betamethasone after 35 weeks of gestation.
TL;DR: Prophylactic betamethasone therapy causes immediate hormonal alterations, which might interfere with the metabolic adaptation of the newborn, and this issue deserves thorough investigation.
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Neonatal glucocorticoid treatment increased depression-like behaviour in adult rats
TL;DR: It is suggested that MAPK signalling cascade in the LA plays an important role in the adverse effect of neonatal DEX treatment on amygdala function, which may result in adverse consequences in adult age, such as the enhancement of susceptibility for a depressive disorder in later life.
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Repeated antenatal corticosteroids: size at birth and subsequent development.
TL;DR: In this cohort study repeated corticosteroid courses were associated with adverse effects on size at birth without apparent benefits, which have the potential to affect later development.
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Cardiovascular risk factors after antenatal exposure to betamethasone : 30-year follow-up of a randomised controlled trial
Stuart R Dalziel,Natalie Walker,Varsha Parag,Colin D. Mantell,Rea Hh,Anthony Rodgers,Jane E. Harding +6 more
TL;DR: Antenatal exposure to betamethasone might result in insulin resistance in adult offspring, but has no clinical effect on cardiovascular risk factors at 30 years of age, and obstetricians should continue to use a single course of antenatal betamETHasone for the prevention of neonatal respiratory distress syndrome.
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