Document Detail


Synthetic glucocorticoids: antenatal administration and long-term implications.
MedLine Citation:
PMID:  15853676     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A clear relationship between intrauterine development and later life predisposition to long-term disease is well established. Weight at birth provides a surrogate measure for fetal development and low birth weight predicts changes in most endocrine axes in adulthood. The exposure of the fetus to elevated levels of either endogenous or synthetic glucocorticoids, pre and periconceptional nutritional status and immediate postnatal development including catch-up growth all contribute substantially to the development of adult onset disease. Fetal exposure to high levels of glucocorticoids has direct clinical relevance. Synthetic glucocorticoids (betamethasone/ dexamethasone) are administered to women at risk of preterm delivery to advance fetal maturation and reduce neonatal morbidity and mortality. However, in human pregnancy, evidence suggests that fetal exposure to synthetic glucocorticoids has detrimental effects on birth outcome, childhood cognition and long-term behavior. Studies in animals have established a link between prenatal exposure to synthetic glucocorticoids and alterations in fetal development as well as changes in placental function. These developmental alterations appear to be permanent. Whether this is the case in humans awaits long-term follow-up of children enrolled in randomized controlled trials of prenatal glucocorticoid therapy. The research challenges in this field are now centered on uncovering the mechanisms by which glucocorticoids are involved in programming the fetus for its future life, and discovering ways in which the effectiveness and safety of antenatal glucocorticoids can be enhanced. The purpose of this mini-review is to provide a background into the use of antenatal synthetic corticosteroids and to highlight and summarize recently published clinical and animal-based studies.
Authors:
D M Sloboda; J R G Challis; T J M Moss; J P Newnham
Related Documents :
9263556 - Pneumothorax in pregnancy associated with cocaine use.
24868516 - Parathyroid carcinoma in pregnancy.
18810616 - Inconsistent report of pre-pregnancy-recognition alcohol use by latinas.
766956 - The effects of gonadal irradiation in clinical radiation therapy: a review.
24378186 - Prevention of preterm delivery in twin pregnancy.
17339036 - Prenatal examination behavior of southeast asian pregnant women in taiwan: a questionna...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current pharmaceutical design     Volume:  11     ISSN:  1381-6128     ISO Abbreviation:  Curr. Pharm. Des.     Publication Date:  2005  
Date Detail:
Created Date:  2005-04-27     Completed Date:  2005-05-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9602487     Medline TA:  Curr Pharm Des     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1459-72     Citation Subset:  IM    
Affiliation:
School of Women's and Infants' Health, The University of Western Australia, Perth, Australia. dsloboda@obsgyn.uwa.edu.au
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Female
Fetus / drug effects*,  embryology
Glucocorticoids / chemical synthesis,  therapeutic use*
Humans
Infant, Newborn
Pregnancy
Respiratory Distress Syndrome, Newborn / prevention & control*
Time Factors
Chemical
Reg. No./Substance:
0/Glucocorticoids

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Roles of methionine suldfoxide reductases in antioxidant defense, protein regulation and survival.
Next Document:  Neuroprotection and regeneration strategies for spinal cord repair.