Dynamics of the fetal adrenal, cholesterol, and apolipoprotein B responses to antenatal betamethasone therapy☆,☆☆,★,★★
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MATERIAL AND METHODS
Umbilical venous serum was obtained at delivery from 136 infants whose mothers had been given a partial or complete course of betamethasone: 1 to 2 intramuscular doses of 12 mg given 12 or 24 hours apart in an attempt to facilitate lung maturation before expected preterm delivery.17 Infants exposed to multiple courses of therapy (usually conducted if delivery did not occur within 1 week of completion of the initial course of treatment) were excluded from these analyses. Twenty-one infants were
RESULTS
Umbilical cord steroids, cholesterol, and apolipoprotein B levels in the betamethasone-treated infants were subdivided according to broad time intervals after initial therapy (Table I). Most of the infants (102/136, 75%) were delivered within the first week after initiation of betamethasone therapy; their serum levels of DHEAS and cortisol were reduced, whereas their total cholesterol concentrations were increased compared with the control group. DHEAS levels were also subnormal among the 16
COMMENT
The acute response of adrenal steroids in the preterm human fetus to intrauterine betamethasone treatment that we found in this study is in general agreement with that described by Ballard et al.15 and that predicted from the studies of others.13, 14 As has been suggested in prior studies of more limited scope,11, 12 we observed that umbilical cord serum levels of cholesterol and apolipoprotein B, the apoprotein of LDL particles, are increased in some infants exposed in utero to synthetic
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Cited by (0)
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From the Department of Obstetrics and Gynecology, University of Alabama at Birmingham.
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Supported by National Institutes of Health grant No. HD 22969.
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Reprint requests: C. Richard Parker, Jr., PhD, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL 35233-7333.
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