Abstract
The effects of maternal dexamethasone treatment on hypothalamic-pituitary-adrenal axis function were determined during basal and hypoxemic conditions in maternal and fetal sheep. Under halothane, ewes and their fetuses were catheterized at 117 d gestation (term = 145 d). Starting at 124 d, the ewes received i.m. injections of two doses of either dexamethasone (12 mg) or saline at 24-h intervals. All animals experienced one episode of hypoxemia when the dexamethasone was present in the maternal and fetal circulations [125 ± 1 d (H1)] and a second episode of hypoxemia when the steroid was no longer detectable in either the maternal or fetal circulations [128 ± 1 d (H2)]. The fall in partial pressure of oxygen in arterial blood in response to hypoxia was similar in the two episodes in both the fetal and the maternal blood. Maternal dexamethasone treatment diminished maternal and fetal basal plasma cortisol but not ACTH during the normoxic period of H1 but not H2. In control animals, hypoxemia induced increases in fetal but not maternal ACTH and cortisol concentrations. In dexamethasone-treated animals, maternal ACTH and cortisol concentrations also remained unchanged from baseline in both H1 and H2. In contrast, fetal plasma ACTH and cortisol responses to hypoxemia were significantly suppressed during H1 but not H2. Correlation of fetal plasma ACTH and cortisol concentrations suggested diminished cortisol output without a change in adrenocortical responsiveness in dexamethasone-treated fetuses during H1 but not H2. Maternal treatment with dexamethasone transiently suppressed maternal and fetal basal hypothalamic-pituitary-adrenal axis function and the fetal plasma ACTH and cortisol responses to acute hypoxemia in sheep.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
Abbreviations
- CBG:
-
corticosteroid-binding globulin
- dGA:
-
days of gestational age
- HPA:
-
hypothalamo-pituitary-adrenal
- POMC:
-
pro-opiomelanocortin
References
Liggins GC 1969 Premature delivery of foetal lambs infused with glucocorticoids. J Endocrinol 45: 515–523
Ballard PL, Ballard RA 1995 Scientific basis and therapeutic regimens for use of antenatal glucocorticoids. Am J Obstet Gynecol 173: 254–262
Crowley PA 1995 Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994. Am J Obstet Gynecol 173: 322–335
NIH Consensus Development Conference 1995 Effect of corticosteroids for fetal maturation on perinatal outcomes. NIH Consensus Development Panel on the Effect of Corticosteroids for Fetal Maturation on Perinatal Outcomes. JAMA 273: 413–418
Fowden AL, Li J, Forhead AJ 1998 Glucocorticoids and the preparation for life after birth: are there long-term consequences of the life insurance?. Proc Nutr Soc 57: 113–122
Crowley P 2000 Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev CD000065
Giussani DA, Spencer JAD, Hanson MA 1994 Fetal cardiovascular reflex responses to hypoxaemia. Fetal Maternal Med Rev 6: 17–37
Huch A, Huch R, Schneider H, Rooth G 1977 Continuous transcutaneous monitoring of fetal oxygen tension during labour. Br J Obstet Gynaecol 84( suppl 1): 1–39
Fletcher AW, Ma XH, Wu WX, Nathanielsz W, McGarrigle HH, Fowden AL, Giussani DA 2004 Antenatal glucocorticoids reset the level of baseline and hypoxia-induced pituitary-adrenal activity in the sheep fetus during late gestation. Am J Physiol Endocrinol Metab 286: E311–E319
Fletcher AJ, Goodfellow MR, Forhead AJ, Gardner DS, McGarrigle HH, Fowden AL, Giussani DA 2000 Low doses of dexamethasone suppress pituitary-adrenal function but augment the glycemic response to acute hypoxemia in fetal sheep during late gestation. Pediatr Res 47: 684–691
Fowden AL, Mijovic J, Silver M 1993 The effects of cortisol on hepatic and renal gluconeogenic enzyme activities in the sheep fetus during late gestation. J Endocrinol 137: 213–222
Armitage P, Berry G 1994 Further Analysis of Straight Line Data. Statistical Methods in Medical Research. Blackwell, Oxford, pp 292–305
Kream J, Mulay S, Fukushima DK, Solomon S 1983 Determination of plasma dexamethasone in the mother and the newborn after administration of the hormone in a clinical trial. J Clin Endocrinol Metab 56: 127–133
Petersen MC, Nation RL, Ashley JJ, McBride WG 1980 The placental transfer of betamethasone. Eur J Clin Pharmacol 18: 245–247
Bennet L, Kozuma S, McGarrigle HH, Hanson MA 1999 Temporal changes in fetal cardiovascular, behavioural, metabolic and endocrine responses to maternally administered dexamethasone in the late gestation fetal sheep. Br J Obstet Gynaecol 106: 331–339
Yang K, Jones SA, Challis JR 1990 Changes in glucocorticoid receptor number in the hypothalamus and pituitary of the sheep fetus with gestational age and after adrenocorticotropin treatment. Endocrinology 126: 11–17
McMillen IC, Antolovich GC, Mercer JE, Perry RA, Silver M 1990 Proopiomelanocortin messenger RNA levels are increased in the anterior pituitary of the sheep fetus after adrenalectomy in late gestation. Neuroendocrinology 52: 297–302
Myers DA, Ding XY, Nathanielsz PW 1991 Effect of fetal adrenalectomy on messenger ribonucleic acid for proopiomelanocortin in the anterior pituitary and for corticotropin-releasing hormone in the paraventricular nucleus of the ovine fetus. Endocrinology 128: 2985–2991
Ozolins IZ, Young IR, McMillen IC 1990 Effect of cortisol infusion on basal and corticotropin-releasing factor (CRF)-stimulated plasma ACTH concentrations in the sheep fetus after surgical isolation of the pituitary. Endocrinology 127: 1833–1840
Fora MA, Butler TG, Rose JC, Schwartz J 1996 Adrenocorticotropin secretion by fetal sheep anterior and intermediate lobe pituitary cells in vitro: effects of gestation and adrenalectomy. Endocrinology 137: 3394–3400
Fora MA, Valego NK, Lively MO, Castro MI, Rose JC 1996 ACTH-like bioactivity and immunoactivity in fetal lamb pituitaries at 0.65 and 0.95 gestation. Reprod Fertil Dev 8: 195–201
Schwartz J, Kleftogiannis F, Jacobs R, Thorburn GD, Crosby SR, White A 1995 Biological activity of adrenocorticotropic hormone precursors on ovine adrenal cells. Am J Physiol 268: E623–E629
Zehnder TJ, Valego NK, Schwartz J, White A, Rose JC 1995 Regulation of bioactive and immunoreactive ACTH secretion by CRF and AVP in sheep fetuses. Am J Physiol 269: E1076–E1082
Zehnder TJ, Valego NK, Schwartz J, Green J, Rose JC 1998 Cortisol infusion depresses the ratio of bioactive to immunoreactive ACTH in adrenalectomized sheep fetuses. Am J Physiol 274: E391–E396
McMillen IC, Merei JJ, White A, Crosby S, Schwartz J 1995 Increasing gestational age and cortisol alter the ratio of ACTH precursors: ACTH secreted from the anterior pituitary of the fetal sheep. J Endocrinol 144: 569–576
Schwartz J, Ash P, Ford V, Raff H, Crosby S, White A 1994 Secretion of adrenocorticotrophin (ACTH) and ACTH precursors in ovine anterior pituitary cells: actions of corticotrophin-releasing hormone, arginine vasopressin and glucocorticoids. J Endocrinol 140: 189–195
Roebuck MM, Jones CT, Holland D, Silman R 1980 In vitro effects of high molecular weight forms of ACTH on the fetal sheep adrenal. Nature 284: 616–618
Berdusco ET, Yang K, Hammond GL, Challis JR 1995 Corticosteroid-binding globulin (CBG) production by hepatic and extra-hepatic sites in the ovine fetus; effects of CBG on glucocorticoid negative feedback on pituitary cells in vitro. J Endocrinol 146: 121–130
Sloboda DM, Newnham JP, Challis JR 2000 Effects of repeated maternal betamethasone administration on growth and hypothalamic-pituitary-adrenal function in the ovine fetus at term. J Endocrinol 165: 79–91
Akagi K, Challis JR 1990 Hormonal and biophysical responses to acute hypoxemia in fetal sheep at 0.7–0.8 gestation. Can J Physiol Pharmacol 68: 1527–1532
Akagi K, Challis JR 1990 Threshold of hormonal and biophysical responses to acute hypoxemia in fetal sheep at different gestational ages. Can J Physiol Pharmacol 68: 549–555
Boddy K, Dawes GS, Fisher R, Pinter S, Robinson JS 1974 Foetal respiratory movements, electrocortical and cardiovascular responses to hypoxaemia and hypercapnia in sheep. J Physiol 243: 599–618
Giussani DA, McGarrigle HH, Moore PJ, Bennet L, Spencer JA, Hanson MA 1994 Carotid sinus nerve section and the increase in plasma cortisol during acute hypoxia in fetal sheep. J Physiol 477: 75–80
Matthews SG, Challis JR 1995 Levels of pro-opiomelanocortin and prolactin mRNA in the fetal sheep pituitary following hypoxaemia and glucocorticoid treatment in late gestation. J Endocrinol 147: 139–146
Norman LJ, Challis JR 1987 Dexamethasone inhibits ovine corticotrophin-releasing factor (oCRF), arginine vasopressin (AVP), and oCRF + AVP stimulated release of ACTH during the last third of pregnancy in the sheep fetus. Can J Physiol Pharmacol 65: 1186–1192
McDonald TJ, Hoffmann GE, Myers DA, Nathanielsz PW 1990 Hypothalamic glucocorticoid implants prevent fetal ovine adrenocorticotropin secretion in response to stress. Endocrinology 127: 2862–2868
Dodic M, May CN, Wintour EM, Coghlan JP 1998 An early prenatal exposure to excess glucocorticoid leads to hypertensive offspring in sheep. Clin Sci (Lond) 94: 149–155
Dodic M, Peers A, Moritz K, Hantzis V, Wintour EM 2002 No evidence for HPA reset in adult sheep with high blood pressure due to short prenatal exposure to dexamethasone. Am J Physiol Regul Integr Comp Physiol 282: R343–R350
Ford LR, Willi SM, Hollis BW, Wright NM 1997 Suppression and recovery of the neonatal hypothalamic-pituitary-adrenal axis after prolonged dexamethasone therapy. J Pediatr 131: 722–726
Terrone DA, Rinehart BK, Rhodes PG, Roberts WE, Miller RC, Martin JN Jr 1999 Multiple courses of betamethasone to enhance fetal lung maturation do not suppress neonatal adrenal response. Am J Obstet Gynecol 180: 1349–1353
Terrone DA, Smith LG Jr, Wolf EJ, Uzbay LA, Sun S, Miller RC 1997 Neonatal effects and serum cortisol levels after multiple courses of maternal corticosteroids. Obstet Gynecol 90: 819–823
Sloboda DM, Moss TJ, Gurrin LC, Newnham JP, Challis JR 2002 The effect of prenatal betamethasone administration on postnatal ovine hypothalamic-pituitary-adrenal function. J Endocrinol 172: 71–81
Jones CT, Luther E, Ritchie JW, Worthington D 1975 The clearance of ACTH from the plasma of adult and fetal sheep. Endocrinology 96: 231–234
Murphy BE, Clark SJ, Donald IR, Pinsky M, Vedady D 1974 Conversion of maternal cortisol to cortisone during placental transfer to the human fetus. Am J Obstet Gynecol 118: 538–541
Edwards AV, Jones CT 1987 The effect of splanchnic nerve section on the sensitivity of the adrenal cortex to adrenocorticotrophin in the calf. J Physiol 390: 23–31
Edwards AV, Jones CT 1987 The effect of splanchnic nerve stimulation on adrenocortical activity in conscious calves. J Physiol 382: 385–396
Edwards AV, Jones CT, Bloom SR 1986 Reduced adrenal cortical sensitivity to ACTH in lambs with cut splanchnic nerves. J Endocrinol 110: 81–85
Riquelme RA, Llanos JA, McGarrigle HH, Sanhueza EM, Hanson MA, Giussani DA 1998 Chemoreflex contribution to adrenocortical function during acute hypoxemia in the llama fetus at 0.6 to 0.7 of gestation. Endocrinology 139: 2564–2570
Acknowledgements
We acknowledge Paul Hughes for help during surgery and Sue Nicholls for the routine care of the animals in this study.
Author information
Authors and Affiliations
Corresponding author
Additional information
This work was supported by Tommy's–the Baby Charity, UK.
Rights and permissions
About this article
Cite this article
Jellyman, J., Gardner, D., McGarrigle, H. et al. Pituitary-Adrenal Responses to Acute Hypoxemia During and After Maternal Dexamethasone Treatment in Sheep. Pediatr Res 56, 864–872 (2004). https://doi.org/10.1203/01.PDR.0000145253.92052.60
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/01.PDR.0000145253.92052.60