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

RNAi therapy mitigates preeclampsia symptoms

November 19, 2018
A collaboration of scientists from the University of Massachusetts Medical School, Beth Israel Deaconess Medical Center and Western Sydney University, have shown that an innovative new type of therapy using small interfering ...

New blood test detects early stage ovarian cancer

November 19, 2018
Research on a bacterial toxin first discovered in Adelaide has led to the development a new blood test for the early diagnosis of ovarian cancer—a disease which kills over 1000 Australian women and 150,000 globally each ...

Human Cell Atlas study reveals maternal immune system modifications in early pregnancy

November 14, 2018
The first Human Cell Atlas study of early pregnancy in humans has shown how the function of the maternal immune system is affected by cells from the developing placenta. Researchers from the Wellcome Sanger Institute, Newcastle ...

Soy formula feeding during infancy associated with severe menstrual pain in adulthood

November 9, 2018
New research suggests that infant girls fed soy formula are more likely to develop severe menstrual pain as young adults. The finding adds to the growing body of literature that suggests exposure to soy formula during early ...

A major role for a small organ in the immune response during pregnancy

November 9, 2018
The immune system of a pregnant woman is altered during pregnancy, but not in the way previously believed, according to results from a study at Linköping University, Sweden. This study, published in the Journal of Allergy ...

Mailed HPV tests can help find women at-risk for cervical cancer, study finds

November 7, 2018
University of North Carolina Lineberger Comprehensive Cancer Center researchers have found that mailing self-collection kits to test for high-risk human papillomavirus infection has the potential to boost cervical cancer ...

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.