Abstract
These studies determined the effects of fetal treatment with betamethasone alone, or in combination with thyroid hormone (thyroxine; T4), on postnatal renal and endocrine adaptations in preterm newborn lambs. Ovine fetuses (126 d of gestation; term = 150 d) received single, ultrasound-guided intramuscular injections of saline, 0.5 mg/kg betamethasone (Celestone Soluspan®, or 0.5 mg/kg betamethasone plus 60 μg/kg T4. After 48 h, lambs were delivered, treated with surfactant (Survanta®, 100 mg/kg), and ventilated for 3 h. Due to maintained urine flow in the betamethasone-treated animals and a significant decrease in the saline group, betamethasone versus saline urine flow values (0.11 ± 0.03versus 0.03 ± 0.004 mL·min-1·kg-1) were significantly elevated by the end of studies. GFR (1.5 ± 0.3 versus 0.8 ± 0.2 mL·min-1·kg-1) and mean blood pressure (61± 4 versus 42 ± 3 mm Hg) values also were higher in the betamethasone-treated animals. Although renal blood flow, renal plasma flow, and fractional sodium excretion rates did not differ, betamethasoneversus saline values for the filtration fraction (11.9 ± 1.5versus 7.4 ± 1.5%) and total sodium reabsorption (196± 38 versus 81 ± 16μEq·min-1·kg-1) were increased. Betamethasoneversus saline treatment also was associated with significant reductions in plasma angiotensin II (125 ± 23 versus 550± 140 pg/mL) and AVP (116 ± 19 versus 230 ± 77 pg/mL) levels. Overall, the effects of combined betamethasone + T4 treatment were similar to the effects of betamethasone alone. Conclusions: 1) fetal betamethasone injection 48 h before delivery stabilizes GFR and significantly alters endocrine function in preterm newborn lambs, and 2) the addition of T4 does not augment betamethasone-induced renal and endocrine responses.
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Abbreviations
- AII:
-
angiotensin II
- ANF:
-
atrial natriuretic factor
- T4:
-
thyroxine
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Acknowledgements
The authors gratefully acknowledge the contributions of Leslie Blount, Glenda Calvario, James Humme, James Surdilla, and Dr. Chung-Ming Chin to the completion of these studies, and the support provided by Rose Jaramillo in preparing the manuscript.
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Supported in part by Baxter Healthcare Corporation, Renal Division Extramural Grant Program, Grant HD-29713 from the National Institutes of Health, and an Established Investigatorship Award (to M.G.E.) from the American Heart Association.
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Ervin, M., Berry, L., Ikegami, M. et al. Single Dose Fetal Betamethasone Administration Stabilizes Postnatal Glomerular Filtration Rate and Alters Endocrine Function in Premature Lambs. Pediatr Res 40, 645–651 (1996). https://doi.org/10.1203/00006450-199611000-00001
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DOI: https://doi.org/10.1203/00006450-199611000-00001
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