Use of Glucocorticoids for the Fetus and Preterm Infant

Susan M Scott; Susan R Rose

doi:10.1016/j.clp.2017.11.002

Use of Glucocorticoids for the Fetus and Preterm Infant

Clin Perinatol. 2018 Mar;45(1):93-102. doi: 10.1016/j.clp.2017.11.002. Epub 2017 Dec 26.

Authors

Susan M Scott¹, Susan R Rose²

Affiliations

¹ University of New Mexico School of Medicine, 2211 Lomas Boulevard, Albuquerque, NM 87131, USA. Electronic address: sscott@salud.unm.edu.
² Cincinnati Children's Hospital Medical Center and University of Cincinnati, MLC 7012, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.

PMID: 29406009
DOI: 10.1016/j.clp.2017.11.002

Abstract

The soon-to-be-delivered fetus and preterm infant have been treated with glucocorticoids to prepare for postnatal life, historically for more than 40 years. The use of glucocorticoids is as much for replacement of cortisol in the setting of a poorly functioning hypothalamic-pituitary-adrenal axis in the preterm infant, as it is for prevention of long-term lung dysfunction. Potential negative effects of glucocorticoid treatment on brain development and function have been observed more often with dexamethasone therapy than with use of other glucocorticoids. Overall, glucocorticoid treatment has improved the outcome of the preterm infant.

Keywords: BPD; Brain development; Fetus; Glucocorticoids; HPA axis; Hypotension; Newborn.

Publication types

Review

MeSH terms

Betamethasone / therapeutic use
Dexamethasone / therapeutic use
Glucocorticoids / metabolism
Glucocorticoids / therapeutic use*
Humans
Hydrocortisone / therapeutic use
Hypothalamo-Hypophyseal System / metabolism
Infant, Extremely Premature
Infant, Newborn
Infant, Premature
Pituitary-Adrenal System / metabolism
Prenatal Care
Respiratory Distress Syndrome, Newborn / drug therapy
Respiratory Distress Syndrome, Newborn / prevention & control*

Substances

Glucocorticoids
Dexamethasone
Betamethasone
Hydrocortisone

Supplementary concepts

Respiratory Distress Syndrome In Premature Infants