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Effect of inhaled glucocorticoid treatment on placental 11beta-hydroxysteroid dehydrogenase type 2 activity and neonatal birthweight in pregnancies complicated by asthma.
- Source :
-
The Australian & New Zealand journal of obstetrics & gynaecology [Aust N Z J Obstet Gynaecol] 2006 Apr; Vol. 46 (2), pp. 136-40. - Publication Year :
- 2006
-
Abstract
- Background: Asthma is a common disease affecting 12% of Australian women with 55% of women experiencing at least one exacerbation during pregnancy. Exacerbations during pregnancy are associated with low birthweight neonates and stillbirth. One of the main reasons for maternal exacerbations during pregnancy is non-compliance with inhaled glucocorticoid treatment due to the misconception that inhaled glucocorticoids are harmful to the fetus.<br />Aims and Methods: We have therefore assessed whether the commonly used inhaled glucocorticoids reduce placental glucocorticoid metabolising capacity, by measuring 11beta-hydroxysteroid dehydrogenase type 2 (11beta-HSD-2) activity. As these treatments potentially increase the exposure of the fetus to the growth-inhibiting effects of glucocorticoids, we also examined the question of whether inhaled glucocorticoid use was associated with reduced birthweight. Pregnant women using budesonide (n = 18), fluticasone propionate alone (n = 14) and fluticasone propionate in combination with the long-acting beta2 agonist salmeterol (n = 9) were compared to a non-asthmatic control group (n = 20).<br />Results: The use of inhaled budesonide was associated with significantly increased placental 11beta-HSD-2 activity relative to the control group. Inhaled glucocorticoid use for the treatment of asthma was associated with normal birthweight. In the small number of women using combination therapy (fluticasone and salmeterol), there was reduced birthweight compared to the control group.<br />Conclusion: Inhaled glucocorticoids alone do not adversely affect fetal growth and placental function.
- Subjects :
- 11-beta-Hydroxysteroid Dehydrogenase Type 2 drug effects
Administration, Inhalation
Adult
Analysis of Variance
Asthma diagnosis
Birth Weight
Case-Control Studies
Female
Follow-Up Studies
Gestational Age
Glucocorticoids adverse effects
Humans
Infant, Newborn
Parity
Placenta chemistry
Placenta drug effects
Pregnancy
Pregnancy Complications diagnosis
Probability
Reference Values
Risk Assessment
11-beta-Hydroxysteroid Dehydrogenase Type 2 metabolism
Asthma drug therapy
Glucocorticoids administration & dosage
Pregnancy Complications drug therapy
Pregnancy Outcome
Subjects
Details
- Language :
- English
- ISSN :
- 0004-8666
- Volume :
- 46
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- The Australian & New Zealand journal of obstetrics & gynaecology
- Publication Type :
- Academic Journal
- Accession number :
- 16638036
- Full Text :
- https://doi.org/10.1111/j.1479-828X.2006.00543.x