Landmark study optimises steroid use in pregnancy

May 15, 2018, Tohoku University
Landmark study optimises steroid use in pregnancy
Credit: Tohoku University

A pioneering research program aiming to optimise steroid use in pregnancy, and minimise potential side effects of excess steroid exposure to both mother and baby, is set to benefit the millions of families worldwide who will have babies born too soon.

The long-standing collaborative Western Australian-based program, involving researchers from the Women and Infants Research Foundation, Cincinnati Children's Hospital, USA, and Tohoku University Hospital, Japan, has sought to investigate the importance of duration and magnitude of steroids exposure to mature the lungs of .

Findings published this week in the American Journal of Obstetrics & Gynecology have shown that in preterm lambs, high peak drug exposures do not contribute to the effectiveness of antennal steroids. Rather, the duration of low-concentration steroid exposure is key for preterm maturation.

Chief Investigator at the University of Western Australia, Associate Professor Matt Kemp, said the findings represent a major breakthrough in the field of obstetrics.

"The use of steroid therapy in pregnancy to rapidly mature the fetal lung, making breathing easier and safer for , has been responsible for saving the lives of countless thousands of preterm babies.

Landmark study optimises steroid use in pregnancy
Credit: Tohoku University

"However, steroid use in pregnancy has never been optimised, meaning that since the 1970s a 50kg woman early in pregnancy is given the same dose of steroids as a 100kg woman close to term.

"Our study has shown, for the first time ever, that it may be possible to achieve maturation of the preterm lung equivalent to that given by current treatments using approximately 70 per cent less drug.

"Given the strong link between excess fetal steroid exposure and growth restriction, and the global use of this drug, these results have the potential to greatly impact the field of antenatal medicine."

Assoc Prof Kemp said that as equally exciting as the research outcomes, was the international collaborative element of the study with the consortium boasting scientists and doctors in Perth, Cincinnati (USA) and Sendai (Japan).

Credit: Tohoku University

Chief Scientific Director of the Women and Infants Research Foundation, Professor John Newnham said the findings represent a clear pathway to optimising health outcomes in cases where preterm birth is inevitable.

"The lungs of extreme premature are often too structurally and functionally under-developed for the baby to breathe easily, and those born at the earliest gestational ages may suffer from severe and life-long problems such as cerebral palsy, developmental delay or blindness," he said.

"Because steroids are powerful drugs that target many organs, some researchers have become concerned about potential side-effects of excess steroid on both mother and the unborn baby.

"This work to determine the lowest possible dose of antenatal steroids to mature the fetal lung underscores the need to develop a far-reaching optimised steroid dosing regimen that can improve both the efficacy and safety of antenatal steroid treatment," Prof Newnham said.

Explore further: Artificial womb raises hope for premature babies

More information: Matthew W. Kemp et al. The efficacy of antenatal steroid therapy is dependent on the duration of low-concentration fetal exposure: Evidence from a sheep model of pregnancy, American Journal of Obstetrics and Gynecology (2018). DOI: 10.1016/j.ajog.2018.05.007

Related Stories

Artificial womb raises hope for premature babies

August 17, 2017
An artificial womb has been successfully used to incubate healthy baby lambs for a period of one week, and researchers hope the technology will one day be able to do the same for extremely premature babies.

SMFM releases statement on use of antenatal corticosteroids in late preterm birth period

April 6, 2016
The Society for Maternal-Fetal Medicine released a statement on the use of antenatal corticosteroids during the late preterm birth period for women at risk of preterm birth. The statement, is currently available online and ...

Research shows efficacy of steroid use in late preterm delivery

March 3, 2016
Current recommendations are for all women who go into labor prior to 34 weeks gestation to be given antenatal corticosteroids (betamethasone) to help mature the baby's lungs. However, many babies born in the late preterm ...

Study finds use of antenatal late preterm steroids reduces neonatal respiratory morbidity

February 1, 2016
In a study to be presented on Feb. 4 in the oral plenary session, at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, in Atlanta, researchers with the Eunice Kennedy Shriver National Institute ...

Prenatal steroids reduce risk of brain bleeding in preemies

March 24, 2016
Prenatal steroid treatment reduces by half a premature baby's risk for a severe form of brain hemorrhage after birth, a study from the Stanford University School of Medicine has found.

Very premature babies benefit most from corticosteroids before birth

March 28, 2017
Giving corticosteroid drugs to mothers at risk of preterm delivery - from as early as 23 weeks of pregnancy - is associated with a lower rate of death and serious illness for their babies, finds a study published by The BMJ ...

Recommended for you

Vendors say pot eases morning sickness. Will baby pay a price?

May 22, 2018
(HealthDay)—Nearly 70 percent of Colorado marijuana dispensaries recommended pot products to manage early pregnancy-related morning sickness, new research reveals.

Pregnancy drug DES might have triggered ADHD in the grandchildren of women who used it

May 21, 2018
A study conducted by researchers at Columbia University's Mailman School of Public Health and Harvard T.H. Chan School of Public Health reported elevated odds for attention deficit hyperactivity disorder (ADHD) in the grandchildren ...

Male depression may lower pregnancy chances among infertile couples, study suggests

May 17, 2018
Among couples being treated for infertility, depression in the male partner was linked to lower pregnancy chances, while depression in the female partner was not found to influence the rate of live birth, according to a study ...

Fertility study finds acupuncture ineffective for IVF birth rates

May 15, 2018
A study of over 800 Australian and New Zealand women undergoing acupuncture treatment during their IVF (in vitro fertilization) cycle has confirmed no significant difference in live birth rates. The findings published today ...

More than one day of first-trimester bleeding ups odds for smaller baby

May 10, 2018
(HealthDay)—Some first-trimester bleeding occurs in up to 1 in every 4 pregnancies. Now, new research suggests that if bleeding extends beyond a day there could be implications for baby's birth weight.

For women with history of pregnancy loss, walking may aid chance of becoming pregnant

May 8, 2018
Results of a recent study to better understand modifiable factors such as physical activity that may affect a woman's ability to conceive a child suggest that walking may help women to improve their chances of becoming pregnant.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.