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Differential Effects of Maternal and Fetal Betamethasone Injections in Late-Gestation Fetal Sheep

School of Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia; Department of Pysiology, Monash University Clayton, Victoria, Australia; Lotteries Commission Perinatal Research Laboratories, School of Women's and Infants' Health. The University of Western Australia, Box M094, 35 Stirling Highway, Crawley, WA 6009 Australia; tmoss{at}cycllene.uwa.edu.au

Ilias Nitsos, PhD

Richard Harding, DSc

John P. Newnham, MD

School of Women's and Infants' Health, University of Western Australia, Perth, Western Australia, Australia; Department of Pysiology, Monash University Clayton, Victoria, Australia

Objective: To determine the effects of single or repeated intramuscular injections of betamethasone, given maternally or directly to the fetus, on chronically catheterized, late-gestation fetal sheep. Methods: Fetal or maternal sheep received either repeated intramuscular injections of betamethasone (0.5 mg/kg body weight at 104, 111, and 118 days' gestation), single betamethasone injection (at 104 days' gestation, followed by saline at 111 and 118 days' gestation), or repeated saline injection; n = 6 or 7 per group. At approximately 130 days' gestation fetuses were catheterized for serial measurements of heart rate, arterial pressure, blood gases, metabolites, and electrolytes. Results: Repeated maternal betamethasone injections reduced birth weight (P = .03) without fetal hypoxemia or hypoglycemia. Circulating fetal calcium and lactate concentrations were reduced (P = .002 and P = .014, respectively) by repeated maternal betamethasone only. Fetal hematocrit tended to be lower after fetal (P = .3) and matenal (P = .07) betamethasone. Conclusion: Growth restriction caused by repeated maternal betamethasone treatments is not due to overt chronic placental insufficiency but may be caused by alterations in hormonal mediators of fetal growth or impairment of placental transport of specific nutrients.

Key Words: Antenatal corticosteroids • intrauterine growth restriction • placenta

Journal of the Society for Gynecologic Investigation, Vol. 10, No. 8, 474-479 (2003)
DOI: 10.1016/S1071-55760300152-7


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