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Randomized Controlled Trial
. 2015 Oct;32(12):1126-32.
doi: 10.1055/s-0035-1549217. Epub 2015 May 8.

Neonatal Genetic Variation in Steroid Metabolism and Key Respiratory Function Genes and Perinatal Outcomes in Single and Multiple Courses of Corticosteroids

K S Borowski  1 , E A S Clark  2 , Y Lai  3 , R J Wapner  4 , Y Sorokin  5 , A M Peaceman  6 , J D Iams  7 , K J Leveno  8 , M Harper  9 , S N Caritis  10 , M Miodovnik  11 , B M Mercer  12 , J M Thorp Jr  13 , M J O'Sullivan  14 , S M Ramin  15 , M W Carpenter  16 , D J Rouse  17 , B Sibai  18 ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network
Collaborators, Affiliations
Randomized Controlled Trial

Neonatal Genetic Variation in Steroid Metabolism and Key Respiratory Function Genes and Perinatal Outcomes in Single and Multiple Courses of Corticosteroids

K S Borowski et al. Am J Perinatol. 2015 Oct.

Abstract

Objective: The aim of the study is to evaluate the association of steroid metabolism and respiratory gene polymorphisms in neonates exposed to antenatal corticosteroids (ACS) with respiratory outcomes, small for gestational age (SGA), and response to repeat ACS.

Study design: This candidate gene study is a secondary analysis of women enrolled in a randomized controlled trial of single versus weekly courses of ACS. Nineteen single nucleotide polymorphisms (SNPs) in 13 steroid metabolism and respiratory function genes were evaluated. DNA was extracted from placenta or fetal cord serum and analyzed with TaqMan genotyping. Each SNP was evaluated for association via logistic regression with respiratory distress syndrome (RDS), continuous positive airway pressure (CPAP)/ventilator use (CPV), and SGA.

Results: CRHBP, CRH, and CRHR1 minor alleles were associated with an increased risk of SGA. HSD11B1 and SCNN1B minor alleles were associated with an increased likelihood of RDS. Carriage of minor alleles in SerpinA6 was associated with an increased risk of CPV. CRH and CRHR1 minor alleles were associated with a decreased likelihood of CPV.

Conclusion: Steroid metabolism and respiratory gene SNPs are associated with respiratory outcomes and SGA in patients exposed to ACS. Risks for respiratory outcomes are affected by minor allele carriage as well as by treatment with multiple ACS.

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