American Journal of Obstetrics & Gynecology
Volume 201, Issue 6 , Pages 611.e1-611.e7 , December 2009

Betamethasone dose and formulation for induced lung maturation in fetal sheep

  • Alan H. Jobe, MD, PhD

      Affiliations

    • Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH
  • ,
  • Ilias Nitsos, PhD

      Affiliations

    • School of Women and Infants' Health, The University of Western Australia, Perth, WA, Australia
  • ,
  • J. Jane Pillow, MD, PhD

      Affiliations

    • School of Women and Infants' Health, The University of Western Australia, Perth, WA, Australia
  • ,
  • Graeme R. Polglase, PhD

      Affiliations

    • School of Women and Infants' Health, The University of Western Australia, Perth, WA, Australia
  • ,
  • Suhas G. Kallapur, MD

      Affiliations

    • Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH
  • ,
  • John P. Newnham, MD

      Affiliations

    • School of Women and Infants' Health, The University of Western Australia, Perth, WA, Australia

Received 6 March 2009 ,Revised 7 May 2009 ,Accepted 6 July 2009.

References 

  1. Roberts D, Dalziel S. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2006;3:CD004454
  2. Crowther CA, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease. Cochrane Database Syst Rev. 2007;3:CD003935
  3. Murphy KE, Hannah ME, Willan AR, et al. Multiple courses of antenatal corticosteroids for preterm birth (MACS): a randomised controlled trial. Lancet. 2009;372:2143–2151
  4. Jobe A, Moss TJM, Nitsos I, Ikegami M, Kallapur SG, Newnham JP. Betamethasone for lung maturation: testing dose and formulation in fetal sheep. Am J Obstet Gynecol. 2007;97:523–526
  5. Brownfoot FC, Crowther CA, Middleton P. Different corticosteroids and regimens for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2008;4:CD006764
  6. Jobe AH, Polk D, Ikegami M, et al. Lung responses to ultrasound-guided fetal treatments with corticosteroids in preterm lambs. J Appl Physiol. 1993;75:2099–2105
  7. Jobe AH, Newnham J, Moss TJ, Ikegami M. Differential effects of maternal betamethasone and cortisol on lung maturation and growth in fetal sheep. Am J Obstet Gynecol. 2003;188:22–28
  8. Berry LM, Polk DH, Ikegami M, Jobe AH, Padbury JF, Ervin MG. Preterm newborn lamb renal and cardiovascular responses after fetal or maternal antenatal betamethasone. Am J Physiol. 1997;272:R1972–R1979
  9. Jobe AH, Newnham J, Willet K, Sly P, Ikegami M. Fetal versus maternal and gestational age effects of repetitive antenatal glucocorticoids. Pediatrics. 1998;102:1116–1125
  10. Jobe AH, Wada N, Berry LM, Ikegami M, Ervin MG. Single and repetitive maternal glucocorticoid exposures reduce fetal growth in sheep. Am J Obstet Gynecol. 1998;178:880–885
  11. Kutzler MA, Ruane EK, Coksaygan T, Vincent SE, Nathanielsz PW. Effects of three courses of maternally administered dexamethasone at 0.7, 0.75, and 0.8 of gestation on prenatal and postnatal growth in sheep. Pediatrics. 2004;113:313–319
  12. Jobe AH, Soll RF. Choice and dose of corticosteroid for antenatal treatments. Am J Obstet Gynecol. 2004;190:878–881
  13. Newnham JP, Polk DH, Kelly RW, et al. Catecholamine response to ultrasonographically guided percutaneous blood sampling in fetal sheep. Am J Obstet Gynecol. 1994;171:460–465
  14. Samtani MN, Lohle M, Grant A, Nathanielsz PW, Jusko WJ. Betamethasone pharmacokinetics after two prodrug formulations in sheep: implications for antenatal corticosteroid use. Drug Metab Dispos. 2005;33:1124–1130
  15. Samtani MN, Schwab M, Nathanielsz PW, Jusko WJ. Stabilization and HPLC analysis of betamethasone sodium phosphate in plasma. J Pharm Sci. 2004;93:726–732
  16. Notter RH, Egan EA, Kwong MS, Holm BA, Shapiro DL. Lung surfactant replacement in premature lambs with extracted lipids from bovine lung lavage: effects of dose, dispersion technique, and gestational age. Pediatr Res. 1985;19:569–577
  17. Jobe AH, Newnham JP, Willet KE, et al. Endotoxin induced lung maturation in preterm lambs is not mediated by cortisol. Am J Respir Crit Care Med. 2000;162:1656–1661
  18. Bachurski CJ, Ross GF, Ikegami M, Kramer BW, Jobe AH. Intra-amniotic endotoxin increases pulmonary surfactant components and induces SP-B processing in fetal sheep. Am J Physiol Lung Cell Mol Physiol. 2001;280:L279–L285
  19. Lee BH, Stoll BJ, McDonald SA, Higgins RD. Adverse neonatal outcomes associated with antenatal dexamethasone versus antenatal betamethasone. Pediatrics. 2006;117:1503–1510
  20. Feldman DM, Carbone J, Belden L, Borgida AF, Herson V. Betamethasone vs dexamethasone for the prevention of morbidity in very-low-birthweight neonates. Am J Obstet Gynecol. 2007;197:284.e1–284.e4
  21. Elimian A, Garry D, Figueroa R, Spitzer A, Wiencek V, Quirk JG. Antenatal betamethasone compared with dexamethasone (betacode trial): a randomized controlled trial. Obstet Gynecol. 2007;110:26–30
  22. Guinn DA, Atkinson MW, Sullivan L, et al. Single vs weekly courses of antenatal corticosteroids for women at risk of preterm delivery: a randomized controlled trial. JAMA. 2001;286:1581–1587
  23. Wapner RJ, Sorokin Y, Thom EA, et al. Single versus weekly courses of antenatal corticosteroids: evaluation of safety and efficacy. Am J Obstet Gynecol. 2006;195:633–642
  24. Kurtzman J, Garite T, Clark R, et al. Network TOCR Impact of a “rescue” course of antenatal corticosteroids (ACS): a multi-center randomized placebo controlled trial [abstract]. Am J Obstet Gynecol. 2008;200:248.e1–248.e9

 Reprints not available from the authors.

 This work was funded in part by Grant HL-65397 and by a Grant from Schering-Plough, Summit, NJ. J.J.P. is supported by a Sylvia and Charles Viertel Senior Medical Research Fellowship. G.R.P. is supported by an NHFA and NHMRC Fellowship. Infrastructure support was provided by the Women and Infants' Research Foundation, Western Australia.

 Cite this article as: Jobe AH, Nitsos I, Pillow JJ, et al. Betamethasone dose and formulation for induced lung maturation in fetal sheep. Am J Obstet Gynecol 2009;201:611.e1-7.

PII: S0002-9378(09)00780-7

doi: 10.1016/j.ajog.2009.07.014

American Journal of Obstetrics & Gynecology
Volume 201, Issue 6 , Pages 611.e1-611.e7 , December 2009