Fetal versus maternal and gestational age effects of repetitive antenatal glucocorticoids

Jobe, Alan H., Newnham, John, Willet, Karen, Sly, Peter and Ikegami, Machiko (1998) Fetal versus maternal and gestational age effects of repetitive antenatal glucocorticoids. Pediatrics, 102 5: 1116-1125. doi:10.1542/peds.102.5.1116

Author Jobe, Alan H.
Newnham, John
Willet, Karen
Sly, Peter
Ikegami, Machiko
Title Fetal versus maternal and gestational age effects of repetitive antenatal glucocorticoids
Journal name Pediatrics   Check publisher's open access policy
ISSN 0031-4005
Publication date 1998-11
Sub-type Article (original research)
DOI 10.1542/peds.102.5.1116
Volume 102
Issue 5
Start page 1116
End page 1125
Total pages 10
Place of publication Elk Grove Village, IL, United States
Publisher American Academy of Pediatrics
Language eng
Formatted abstract
Although single courses of antenatal glucocorticoids decrease respiratory distress syndrome and mortality, repetitive courses of antenatal glucocorticoids are being given to women at risk of preterm delivery without evidence of benefit or appreciation of potential risks.


To evaluate the effects of single and repetitive antenatal glucocorticoid exposures on fetal growth and postnatal lung function in sheep.


Pregnant ewes were randomized to three protocols that included one or three doses (at 7-day intervals) of 0.5 mg/kg of betamethasone (β) given to the ewe or fetus beginning at gestations ranging from 104 to 128 days' gestation with delivery at 125, 135, and 146 days' gestation. Postnatal assessments included measurements of gas exchange, compliance, ventilation efficiency, static lung volume, and lung tissue and alveolar wash saturated phosphatidylcholine.


Single or repetitive maternal β but not fetal β caused fetal growth retardation at delivery at 125, 135, and 146 days' gestation. Single-dose fetal β had no effect on postnatal lung function whereas single-dose maternal significantly increased compliance, lung volume, and tissue and alveolar surfactant after preterm delivery. Although three-dose fetal β improved all indicators of postnatal lung function, three-dose maternal β resulted in larger responses. The added benefits of repetitive β relative to a single-dose β on postnatal lung function after preterm delivery were not as great when therapy was begun later in gestation. Postnatal lung function after delivery at 146 days' gestation (term is 150 days) was improved after repetitive maternal β at early gestational age.


In sheep, single or repetitive maternal causes growth retardation from 104 to 121 days' gestation and the growth retardation persists to term. In contrast, single or repetitive fetal β does not cause fetal growth retardation and is less potent at improving postnatal lung function and increasing surfactant pools. There are potential benefits as well as risks for the use of repetitive antenatal glucocorticoids. Randomized, controlled trials in humans are essential given the widespread use of repetitive courses of antenatal glucocorticoids in women at risk of preterm delivery.
Keyword Respiratory distress syndrome
Growth retardation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Wed, 17 Nov 2010, 11:33:57 EST