Journal article
Continuous but not pulsed low-dose fetal betamethasone exposures extend the durability of antenatal steroid therapy
American Journal of Physiology-Lung Cellular and Molecular Physiology, Vol.322(6), pp.L784-L793
2022
Abstract
Antenatal steroid (ANS) therapy is the standard care for women at imminent risk of preterm labor. Despite extensive and long-standing use, 40%–50% of babies exposed antenatally to steroids do not derive benefit; remaining undelivered 7 days or more after ANS treatment is associated with a lack of treatment benefit and increased risk of harm. We used a pregnant sheep model to evaluate the impact of continuous versus pulsed ANS treatments on fetal lung maturation at an extended, 8-day treatment to delivery interval. Continuous low-dose ANS treatments for more than 72 h in duration improved fetal lung maturation at 8 days after treatment initiation. If fetal ANS exposure was interrupted, the beneficial ANS effect was lost. Truncated treatments, including that simulating the current clinical treatment regimen, did not improve lung function. Variable fetal lung maturation was correlated to the amount of saturated phosphatidylcholine present in the lung fluid. These data demonstrate that 1) the durability of ANS therapy may be enhanced by employing an extended, low-dose treatment regimen by reducing total dose and 2) interrupting the continuity of fetal exposure by allowing it to fall below a minimal threshold was associated with comparably poor functional maturation of the preterm ovine lung.
Details
- Title
- Continuous but not pulsed low-dose fetal betamethasone exposures extend the durability of antenatal steroid therapy
- Authors/Creators
- T. Takahashi (Author/Creator) - Tohoku University HospitalY. Takahashi (Author/Creator) - Tohoku University HospitalE.L. Fee (Author/Creator) - The University of Western AustraliaM. Saito (Author/Creator) - The University of Western AustraliaN. Yaegashi (Author/Creator) - Tohoku University HospitalH. Usuda (Author/Creator) - The University of Western AustraliaJ.P. Bridges (Author/Creator) - University of Colorado Anschutz Medical CampusM.A. Milad (Author/Creator) - Product Innovation and Engineering (United States) (United States, Saint James) - LLCL. Furfaro (Author/Creator) - The University of Western AustraliaS. Carter (Author/Creator) - The University of Western AustraliaA.F. Schmidt (Author/Creator) - Cincinnati Children's Hospital Medical CenterJ.P. Newnham (Author/Creator) - The University of Western AustraliaA.H. Jobe (Author/Creator) - Cincinnati Children's Hospital Medical CenterM.W. Kemp (Author/Creator) - The University of Western Australia
- Publication Details
- American Journal of Physiology-Lung Cellular and Molecular Physiology, Vol.322(6), pp.L784-L793
- Publisher
- American Physiological Society
- Identifiers
- 991005542713007891
- Copyright
- © 2022 the American Physiological Society
- Murdoch Affiliation
- School of Veterinary and Life Sciences
- Language
- English
- Resource Type
- Journal article
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Source: InCites
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- Collaboration types
- Domestic collaboration
- International collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.72 Obstetrics & Gynecology
- 1.72.924 Preterm Birth Causes
- Web Of Science research areas
- Physiology
- Respiratory System
- ESI research areas
- Clinical Medicine