• Leonhard Schäffer, Franziska Luzi, Tilo Burkhardt, Manfred Rauh, and Ernst Beinder.
• Department of Obstetrics and Gynecology, University of Zuürich, Zuürich, Switzerland. schaffer@usz.chscheffer@ugz.ch
• Obstet Gynecol. 2009 May 1; 113 (5): 1082-8.

ObjectiveTo analyze hypothalamic-pituitary-adrenal axis balance in healthy newborns after antenatal betamethasone treatment for lung maturation where delivery could be prolonged until or near term.MethodsIn a prospective observational study, salivary cortisol and cortisone levels were measured at the fourth day of life during resting conditions and in response to a pain-induced stress event in 23 neonates with antenatal exposure to a single course of betamethasone (2x12 mg) and compared with 40 controls. The mean interval between betamethasone treatment and delivery was 60+/-23 days.ResultsOn day 4 of life, neonates in the control group exhibited a significant increase in cortisol and cortisone from baseline levels after the stress induction (1.175-2.4 ng/mL for cortisol and 11.35-18.15 ng/mL for cortisone [both P<.05]), whereas, in betamethasone-exposed neonates, cortisol and cortisone stress response was not significantly different from baseline levels (1.39-1.6 ng/mL for cortisone [P=.76] and 14.8-17.1 ng/mL for cortisol [P=.69]). No influence of gestational age at betamethasone administration (P=.76) or gestational age at delivery (P=.71) on stress response patterns was observed in a multiple stepwise regression.ConclusionA single course of antenatal betamethasone treatment induces a suppression of stress reactivity in healthy newborns.

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