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Effects of maternal betamethasone administration on fetal and maternal blood pressure and heart rate in the baboon at 0.7 of gestation

      Abstract

      Objective: We sought to determine the effects of the intramuscular maternal administration of betamethasone to the pregnant baboon at 0.7 of gestation on fetal blood pressure and heart rate. Study design: We treated pregnant baboons at 0.7 of gestation with intramuscular betamethasone (n = 4), at a weight-adjusted dose equivalent to the daily dose administered to women in preterm labor or with saline solution (n = 5). Four injections were given at 12-hour intervals. Fetal and maternal blood pressure and heart rate were recorded continuously. Within-group differences and between-group differences were analyzed with repeated measures analysis of variance. Results: Fetal blood pressure increased significantly after betamethasone treatment. Fetal heart rate, maternal blood pressure, and heart rate did not change. Conclusion: Exposure of the developing primate fetus to exogenous glucocorticoid at 0.7 of gestation elevates fetal blood pressure. These findings confirm and extend the observations in the fetal sheep. Further studies are needed to evaluate the mechanisms that are involved and possible long-term consequences of these cardiovascular effects of antenatal glucocorticoid exposure in the fetal primate. (Am J Obstet Gynecol 2002;186:812-7.)

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      References

        • Liggins GC
        Premature delivery of foetal lambs infused with glucocorticoids.
        J Endocrinol. 1969; 45: 515-523
        • NIH Consensus Development Conference
        Effect of corticosteroids for fetal maturation on perinatal outcomes.
        JAMA. 1995; 273: 413-418
        • Magee LA
        • Dawes GS
        • Moulden M
        • Redman CWG
        A randomized controlled comparison of betamethasone with dexamethasone: effects on the antenatal fetal heart rate.
        Br J Obstet Gynaecol. 1997; 104: 1233-1238
        • Mulder EJH
        • Derks JB
        • Visser GHA
        Antenatal corticosteroid therapy and fetal behaviour: a randomized study of the effects of betamethasone and dexamethasone.
        Br J Obstet Gynaecol. 1997; 104: 1239-1247
        • Wood CE
        • Cheung CY
        • Brace RA
        Fetal heart rate, arterial pressure, and blood volume responses to cortisol infusion.
        Am Physiol Soc. 1987; 253: R904-R909
        • Derks JB
        • Giussani DA
        • Jenkins SL
        • Wentworth RA
        • Visser GHA
        • Padbury JF
        • et al.
        A comparative study of cardiovascular, endocrine and behavioral effects of betamethasone and dexamethasone administration to fetal sheep.
        J Physiol. 1997; 499: 217-226
        • Honnebier MBOM
        • Jenkins SL
        • Nathanielsz PW
        Circadian timekeeping during pregnancy: endogenous phase relationships between maternal plasma hormones and the maternal body temperature rhythm in pregnant rhesus monkeys.
        Endocrinology. 1992; 131: 2051-2058
        • Ballard PL
        • Ballard RA
        Scientific basis and therapeutic regimens for use of antenatal glucocorticoids.
        Am J Obstet Gynecol. 1995; 173: 254-262
        • May CN
        • Bednarik JA
        Regional hemodynamic and endocrine effects of aldosterone and cortisol in conscious sheep: comparison with the effects of corticotropin.
        Hypertension. 1995; 26: 294-300
        • Whitworth JA
        • Brown MA
        • Kelly JJ
        • Williamson PM
        Mechanisms of cortisol induced hypertension in humans.
        Steroids. 1995; 160: 76-80
        • Haynes R
        Adrenocorticotropic hormone: adrenocortical steroids and their synthetic analogs; inhibitors of the synthesis and actions of adrenocortical hormones.
        in: The pharmacological basis of therapeutics. : Pergamon Press, New York1990: 1431-1462
        • Schwab M
        • Roedel M
        • Anwar MA
        • Muller T
        • Schubert H
        • Buchwalder LF
        • et al.
        Effects of betamethasone administration to the fetal sheep in late gestation on fetal cerebral blood flow.
        J Physiol. 2000; 528: 619-632
        • Anwar MA
        • Schwab M
        • Poston L
        • Nathanielsz PW
        Betamethasone mediated vascular dysfunction and changes in hematological profile in the ovine fetus.
        Am J Physiol. 1999; 276: H1137-H1143
        • Walker BR
        • Williams BC
        Corticosteroids and vascular tone: mapping the messenger maze.
        Clin Sci. 1992; 82: 597-605
        • Kornel L
        • Prancan AV
        • Kanamarlapudi N
        • Hynes J
        • Kuzianik E
        Study on the mechanisms of glucocorticoid-induced hypertension: glucocorticoids increase transmembrane Ca2+ influx in vascular smooth muscle in vivo.
        Endocrinol Res. 1995; 21: 203-210
        • Docherty CC
        • Kalmar-Nagy J
        • Engelen M
        • Koenen SV
        • Nijland MJ
        • Nathanielsz PW
        Effect of in vivo infusion of dexamethasone at 0.75 gestation on responses to endothelin-1 in isolated fetal ovine resistance arteries.
        Am J Physiol. 2001; 281: R261-R268
        • Czerwinski SM
        • McKee EE
        • Hickson RC
        Glucocorticoid receptor activation in isolated perfused rat hearts.
        Am J Physiol. 1989; 256: C219-C225
        • Trenque T
        • Lamiable D
        • Vistelle R
        • Millart H
        • Leperre A
        • Choisy H
        Comparative pharmacokinetics of two diastereoisomers dexa-methasone and betamethasone in plasma and cerebrospinal fluid.
        Fundam Clin Pharmacol. 1994; 8: 430-436
        • Zhu DN
        • Xue LM
        • Li P
        Cardiovascular effects of microinjection of corticoids and antagonists into the rostral ventrolateral medulla in rats.
        Blood Press. 1995; 4: 55-62
        • Segar JL
        • Lumbers ER
        • Nuyt AM
        • Smith OJ
        • Robillard JE
        Effect of antenatal glucocorticoids on sympathetic nerve activity at birth in preterm sheep.
        Am J Physiol. 1998; 274: R160-R167
        • Crowley PA
        Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994.
        Am J Obstet Gynecol. 1995; 173: 322-335
        • Moise AA
        • Wearden ME
        • Kozinetz CA
        • Gest AL
        • Welty SE
        • Hansen TN
        Antenatal steroids are associated with less need for blood pressure support in extremely premature infants.
        Pediatrics. 1995; 95: 845-850
        • Miall-Allen VM
        • De Vries LS
        • Whitelaw AGL
        Mean arterial blood pressure and neonatal cerebral lesions.
        Arch Dis Child. 1987; 62: 1068-1069
        • Low JA
        • Froese AB
        • Galbraith RS
        • Smith JT
        • Sauerbrei EE
        • Derrick EJ
        The association between preterm newborn hypotension and hypoxemia and outcome during the first year.
        Acta Paediatr. 1993; 82: 433-437
        • Koenen SV
        • Nijland MJ
        • Jenkins SL
        • Nathanielsz PW
        Fetal blood pressure response to repeated maternal dexamethasone (DM) administration at 0.68 and 0.75 gestation [abstract].
        J Soc Gynecol Invest. 2001; 8: 108A