1. Sex-specific alterations in placental 11 [beta]-hydroxysteroid dehydrogenase 2 activity and early postnatal clinical course following antenatal betamethasone
- Author
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Stark, Michael J., Wright, Ian M.R., and Clifton, Vicki L.
- Subjects
Betamethasone -- Usage ,Betamethasone -- Health aspects ,Oxidoreductases -- Physiological aspects ,Oxidoreductases -- Research ,Infants (Premature) -- Physiological aspects ,Infants (Premature) -- Health aspects ,Biological sciences - Abstract
Placental 11[beta]-hydroxysteroid dehydrogenase-2 (ll[beta]HSD2) limits fetal glucocorticoid exposure and is associated with physiological stability in the premature newborn infant. Antenatal betamethasone alters 11[beta]HSD2 activity and confers sex-specific advantages in neonatal outcome. We investigated the influence of betamethasone and sex on 11[beta]HSD2 activity, neonatal adrenal function and clinical course in 24- to 36-wk gestation neonates from birth to day 5 of life. Univariate analyses demonstrated an interaction between timing of betamethasone exposure and sex for 11[beta]HSD2 activity rate (P = 0.02) and umbilical arterial cortisol (P = 0.01). For infants born < 72 h following antenatal betamethasone, females had higher 11[beta]HSD2 activity (P < 0.01) and umbilical arterial cortisol (P = 0.01) than males. Females born < 72 h of betamethasone exposure had higher day 1 urinary cortisol, if exposed to perinatal stress, than males (P < 0.01). For infants born < 72 h after betamethasone exposure, 11[beta]HSD2 activity was negatively correlated with Clinical Illness Severity Score score (r = -0.79 P = 0.01) and positively correlated with mean arterial blood pressure (r = 0.8 P = 0.01) only in females. Sex-specific placental 11BHSD2 autoregulation following antenatal betamethasone exposure may limit adrenal suppression in females influencing physiological stability following preterm birth. A lack of adjustment in 11 [beta]HSD2 and adrenal response may contribute to the increased incidence of poor outcome observed in preterm males. placenta; fetal sex
- Published
- 2009