Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 7:57:e20230129.
doi: 10.1590/0100-3984.2023.0129. eCollection 2024 Jan-Dec.

Effects of antenatal corticosteroids on fetal hemodynamics: a longitudinal study

Maria Claudia Bayão Carelli  1 , Fernando Maia Peixoto-Filho  1   2 , Luis Guillermo Coca Velarde  3 , Renato Augusto Moreira de Sá  1   3 , Viviane Monteiro  2 , Edward Araujo Júnior  4   5
Affiliations

Effects of antenatal corticosteroids on fetal hemodynamics: a longitudinal study

Maria Claudia Bayão Carelli et al. Radiol Bras. .

Abstract
in English, Portuguese

Objective: To study the effect of antenatal corticosteroid administration on fetal hemodynamics using longitudinal analysis of Doppler waveforms in the umbilical artery (UA) and middle cerebral artery (MCA).

Materials and methods: This was a retrospective study that included 30 fetuses at risk for preterm birth. Twenty-eight pregnant women were treated with betamethasone for fetal lung maturation. Doppler examinations of the UA and MCA were performed once before and three or eight times after corticosteroid administration. We used a Bayesian hierarchical linear model. Reference ranges were constructed, and associations between variables (gestational age and pre-eclampsia) were tested.

Results: The mean maternal age, gestational age at betamethasone administration, and gestational age at delivery were 32.6 ± 5.89 years, 30.2 ± 2.59 weeks, and 32.9 ± 3.42 weeks, respectively. On UA Doppler, there was a significant decrease in the pulsatility index (PI) after corticosteroid administration, with a mean of 0.1147 (credibility interval: 0.03687-0.191) in three observations and a median of 0.1437 (credibility interval: 0.02509-0.2627) in eight observations. However, there was no significant change in the Doppler MCA PI, regardless of gestational age and the presence or absence of pre-eclampsia.

Conclusion: Although antenatal corticosteroid administration induced a significant decrease in the Doppler UA PI, we observed no change in the cerebral vasculature.

Objetivo: Estudar o efeito da administração antenatal de corticosteroides na hemodinâmica fetal mediante análise longitudinal do Doppler na artéria umbilical (AU) e artéria cerebral média (ACM).

Materiais e métodos: Este foi um estudo retrospectivo que incluiu 30 fetos com risco de nascimento pré-termo. Vinte e oito gestantes foram tratadas com betametasona para maturação pulmonar fetal. Os exames de Doppler da AU e da ACM foram realizados uma vez antes e depois da administração de corticosteroides, num total de três ou oito observações. Utilizamos o modelo linear hierárquico com abordagem Bayesiana. Foram construídos os intervalos de referência e testadas associações entre variáveis (idade gestacional e pré-eclâmpsia).

Resultados: A média ± desvio-padrão da idade materna, idade gestacional na administração de betametasona e idade gestacional no parto foram 32,6 ± 5,89 anos, 30,2 ± 2,59 semanas e 32,9 ± 3,42 semanas, respectivamente. No Doppler da AU, verificou-se diminuição significativa do índice de pulsatilidade (IP) com a terapêutica com corticosteroides (média: 0,1147 [0,03687-0,191]; em três observações) (mediana: 0,1437 [0,02509-0,2627]; em oito observações). No entanto, não foi observada alteração significativa no IP do Doppler da ACM, independentemente da idade gestacional e do diagnóstico de pré-eclâmpsia.

Conclusão: Os corticosteroides pré-natais induziram diminuição significativa no IP do Doppler da AU, mas não houve alteração na vasculatura cerebral.

Keywords: Adrenal cortex hormones/administration & dosage; Betamethasone/administration & dosage; Doppler/methods; Fetal growth retardation/diagnostic imaging; Middle cerebral artery/diagnostic imaging; Ultrasonography; Umbilical arteries/diagnostic imaging.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Longitudinal changes in the UA PI in 30 fetuses during serial follow-up after betamethasone administration (three observations per fetus). Each colored line represents an individual fetus.
Figure 2
Figure 2
Longitudinal changes in the UA PI in 13 fetuses during serial follow-up after betamethasone administration (eight observations per fetus). Each colored line represents an individual fetus.
Figure 3
Figure 3
Longitudinal changes in the MCA PI in 27 fetuses during serial follow-up after betamethasone administration (three observations per fetus). Each colored line represents an individual fetus.
Figure 4
Figure 4
Longitudinal changes in the MCA PI in 12 fetuses during serial follow-up after betamethasone administration (eight observations per fetus). Each colored line represents an individual fetus.
See this image and copyright information in PMC

References

    1. Howson CP, Kinney MV, McDougal L. Born Too Soon Preterm Birth Action Group. Born too soon: preterm birth matters. Reprod Health. 2013;10(Suppl 1):S1. - PMC - PubMed
    1. Roberts D, Brown J, Medley N, et al. Antenatal corticosteroids for accelerating fetal lung maturation for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3:CD004454. - PMC - PubMed
    1. Mulder EJH, de Heus R, Visser GHA. Antenatal corticosteroid therapy: short-term effects on fetal behaviour and haemodynamics. Semin Fetal Neonatal Med. 2009;14:151–156. - PubMed
    1. Rotmensch S, Liberati M, Celentano C, et al. The effect of betamethasone on fetal biophysical activities and Doppler velocimetry of umbilical and middle cerebral arteries. Acta Obstet Gynecol Scand. 1999;78:768–773. - PubMed
    1. Derks JB, Mulder EJ, Visser GH. The effects of maternal betamethasone administration on the fetus. Br J Obstet Gynaecol. 1995;102:40–46. - PubMed

LinkOut - more resources