Exposure to repeat doses of antenatal glucocorticoids is associated with altered cardiovascular status after birth

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dc.contributor.author Mildenhall, LFJ en
dc.contributor.author Battin, MR en
dc.contributor.author Morton, SMB en
dc.contributor.author Bevan, C en
dc.contributor.author Kuschel, CA en
dc.contributor.author Harding, JE en
dc.date.accessioned 2011-02-03T02:33:54Z en
dc.date.available 2011-02-03T02:33:54Z en
dc.date.issued 2006 en
dc.identifier.citation Archives of Disease in Childhood. Fetal and Neonatal Edition 91(1): F56-F60 2006 en
dc.identifier.issn 1359-2998 en
dc.identifier.uri http://hdl.handle.net/2292/6344 en
dc.description.abstract Objective: To determine if exposure to more than one course of antenatal glucocorticoids is associated with changes in infant blood pressure and myocardial wall thickness in the first month after birth.Design: Prospective cohort study.Setting: Tertiary neonatal intensive care unit.Participants: Mothers who were eligible for but declined to enter a randomised trial of repeated doses of antenatal glucocorticoids (ACTORDS)-that is, who had a singleton, twin, or triplet pregnancy at < 32 weeks gestation, had received an initial course of glucocorticoids seven or more days previously, and were considered to be at continued risk of preterm birth.Main outcome measures: Blood pressure daily for the first week then weekly until 4 weeks of age. End diastolic interventricular septal and left ventricular posterior wall (EDIVS and EDLVPW) thickness at 48-72 hours after birth.Results: Thirty seven women were enrolled and delivered 50 infants. Thirty mothers (39 infants) were exposed to one course of glucocorticoids, and seven mothers (11 infants) to more than one course. Blood pressures were higher in the first week after birth in infants exposed to multiple courses of glucocorticoids, and in infants with a latency between last exposure and delivery of less than seven days. Systolic blood pressure on day 1 was > 2SD above published normal ranges in 67% of babies exposed to multiple courses and 24% of babies exposed to a single course of glucocorticoids (p = 0.04). There was no difference between groups in thickness of the EDIVS or EDLVPW. However, 44/50 (88%) babies had EDIVS and 49/50 (98%) babies had EDLVPW thickness > 2 SD above the expected mean for birth weight and gestation. EDIVS but not EDLVPW thickness increased with increasing latency (mean 0.02 mm/day, p = 0.03).Conclusion: Future randomised trials should assess the long term effects of exposure to antenatal glucocorticoids, particularly multiple courses, on the cardiovascular status of the infant. en
dc.language EN en
dc.publisher B M J PUBLISHING GROUP en
dc.relation.ispartof Archives of Disease in Childhood. Fetal and Neonatal Edition en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. Details obtained from http://www.sherpa.ac.uk/romeo/issn/1359-2998/ en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.source.uri http://dx.doi.org/10.1136/adc.2004.065300 en
dc.subject BRONCHOPULMONARY DYSPLASIA en
dc.subject PRETERM INFANTS en
dc.subject ECHOCARDIOGRAPHIC MEASUREMENTS en
dc.subject DEXAMETHASONE TREATMENT en
dc.subject PREMATURE-INFANTS en
dc.subject BLOOD-PRESSURE en
dc.subject CORTICOSTEROIDS en
dc.subject COURSES en
dc.subject CARDIOMYOPATHY en
dc.subject THERAPY en
dc.title Exposure to repeat doses of antenatal glucocorticoids is associated with altered cardiovascular status after birth en
dc.type Journal Article en
dc.identifier.doi 10.1136/adc.2004.065300 en
pubs.issue 1 en
pubs.begin-page F56 en
pubs.volume 91 en
dc.rights.holder Copyright: BMJ Publishing Group Ltd. en
pubs.local.anzsrc Paediatrics and Reproductive Medicine en
pubs.end-page F60 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 44785 en
pubs.org-id Faculty of Medical & Hlth Sci en
pubs.org-id Population Health en
pubs.org-id SOPH General Admin en
pubs.org-id School of Medicine en
pubs.org-id Paediatrics Department en
pubs.org-id Liggins Institute en
pubs.org-id Research Programmes en


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