Influence of antenatal steroids and sex on maturation of the epidermal barrier in the preterm infant
Anoo Jaina, Nicholas Ruttera, Patrick H T Cartlidgeb
a Academic Division of
Child Health, Nottingham City Hospital, University of Nottingham,
Hucknall Road, Nottingham NG5 1PB, UK, b Department of Child Health, University of
Wales College of Medicine, Cardiff CF14 4XW, UK
Correspondence to: Professor Rutter, Academic Division of Child Health, School of Human Development, Queen's Medical Centre, Nottingham NG7 2UH, UK email: Nick.Rutter{at}nottingham.ac.uk
Accepted 4 May 2000
BACKGROUND
The
epidermal barrier is well developed in term infants but defective in
the immature infant with important clinical consequences. The
development of the barrier shares similarities with production of
pulmonary surfactant. Studies in the rat have shown that barrier maturation is accelerated by antenatal steroids, both structurally and
functionally. Females have a more mature barrier than males at the same
gestational age. These factors have not been studied in the human.
AIMTo examine the
influence of antenatal steroids and sex on maturation of the epidermal
barrier in the preterm infant.
SUBJECTSA total of
137 infants born before 34 weeks gestation, 80 boys and 57 girls, were
studied: 87 had been exposed to antenatal steroids, and 50 had not; 99 were studied prospectively, and 38 had been studied previously.
METHODBarrier
function was measured as transepidermal water loss from abdominal skin
by evaporimetry. Measurements were made within the first 48 hours and
corrected to a standard relative humidity of 50% (TEWL50).
RESULTSThe relation
between TEWL50 and gestation was exponential with very high
levels in the most immature infants. No influence of antenatal steroids
or sex could be shown. When infants who were optimally exposed to
antenatal steroids were considered alone, no effect could be shown.
CONCLUSIONEpidermal
maturation in the preterm infant does not appear to be influenced by
antenatal steroids or sex, suggesting that the mechanism of maturation
differs from that of the rat.
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Key messages
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Keywords: transepidermal water loss; antenatal steroids; epidermal barrier; prematurity; sex
© 2000 by Archives of Disease in Childhood
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