The continued use of the steroid dexamethasone before birth for the prevention of fetal respiratory distress syndrome in premature infants appears to have only short duration effects on the fetus, according to an article published in February’s BJOG (British Journal of Obstetrics and Gynaecology).
Potent steroids given before birth can reduce the complications of preterm birth and markedly improve the survival of premature babies. Currently no other treatment is as effective, but there has been increasing concern that exposure to steroids before birth may alter the development of the cardiovascular system leading to blood pressure problems in adult life.
But researchers in New Zealand looked at the effects of a single course of dexamethasone in a fetal experimental model, and demonstrated only temporary changes in blood pressure suggesting no long-term adverse effects. Their study suggests that a single course of prenatal steroids for the prevention of fetal respiratory distress syndrome in premature infants can be continued safely.
Dr Laura Bennet, lead author says, “Steroids don’t just target the lungs and there has been great concern in recent years that steroids given to mums before they deliver, which crosses over to the fetus, may affect the normal development of fetal organs such as the heart and brain. Numerous studies have disturbingly shown that repeated or continuous exposure of the fetus to steroids is bad raising the important question: should we stop using steroids altogether? This would of course have consequences for the well-being of newborn babies.
Our study aimed to see if a single course of treatment had the same bad effects on the fetal cardiovascular system as repeated treatments do. Our results show that it does not appear to, and this is very reassuring. We are currently conducting more experiments to verify these results and to make sure that even limited exposure of the fetus to steroids really does not cause problems at this most vulnerable time in life.”
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