Abstract
The short-term (0–48 h) effects of maternal betamethasone administration on computerized fetal heart rate (FHR) parameters were studied in 36 pregnancies at increased risk for preterm delivery. FHR was recorded for 90 min immediately before the start of betamethasone treatment and again at 6-h intervals during the next 48 h. Multiple linear regression models were used to assess the possible effects on FHR parameters of gestational age, time of day, clinical indication for treatment, and use of tocolytic drugs. Within 12 h after the start of treatment, significant increases occurred in FHR accelerations, and short- and long-term FHR variability (36%, 28%, and 22%, respectively), whereas basal FHR showed a 5% decrease. FHR variability was decreased by 10% at 42–48 h. The observed changes were more pronounced in older (29–33 wk of gestation) compared with younger fetuses (25–28 wk of gestation). Decelerations occurred only in 4 out of 11 compromised fetuses during betamethasone therapy. We conclude that there are significant changes in FHR parameters during the first 48 h after betamethasone administration. These changes are transient in normal fetuses. However, the compromised fetus may be adversely affected by betamethasone.
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
- ACC:
-
number of fetal heart rate accelerations
- FHR:
-
fetal heart rate
- LTV:
-
long-term variability
- STV:
-
short-term variability
References
NIH Consensus Development Conference 1995 Effects of corticosteroids for fetal maturation on perinatal outcomes. JAMA 273: 413–418
Crowley P 2003 Prophylactic corticosteroids for preterm birth. Cochrane Database Syst Rev CD000065
Bos AF, van Asperen RM, van Eykern LA, Zijlstra WG, Okken A 1994 Heart rate, heart rate variability and metabolic rate in preterm infants with bronchopulmonary dysplasia in the first week of dexamethasone treatment. J Physiol 479: P23–P24
Kavelaars A, van der Pompe G, Bakker JM, van Hasselt PM, Cats B, Visser GH, Heijnen CJ 1999 Altered immune function in human newborns after prenatal administration of betamethasone: enhanced natural killer cell activity and decreased T cell proliferation in cord blood. Pediatr Res 45: 306–312
Mulder EJ, Derks JB, Visser GH 1997 Antenatal corticosteroid therapy and fetal behaviour. a randomized study of the effects of betamethasone and dexamethasone. Br J Obstet Gynaecol 104: 1239–1247
Magee LA, Dawes GS, Moulden M, Redman CW 1997 A randomised controlled comparison of betamethasone and dexamethasone: effects on the antenatal fetal heart rate. Br J Obstet Gynaecol 104: 1233–1238
Senat MV, Minoui S, Multon O, Fernandez H, Frydman R, Ville Y 1998 Effect of dexamethasone and betamethasone on fetal heart rate variability in preterm labour: a randomised study. Br J Obstet Gynaecol 105: 749–755
Derks JB, Mulder EJ, Visser GH 1995 The effects of maternal betamethasone administration on the fetus. Br J Obstet Gynaecol 102: 40–46
Kelly MK, Schneider EP, Petrikovsky BM, Lesser ML 2000 Effect of antenatal steroid administration on the fetal biophysical profile. J Clin Ultrasound 28: 224–226
Subtil D, Tiberghien P, Devos P, Therby D, Leclerc G, Vaast P, Puech F 2003 Immediate and delayed effects of antenatal corticosteroids on fetal heart rate: a randomized trial that compares betamethasone acetate and phosphate, betamethasone phosphate, and dexamethasone. Am J Obstet Gynecol 188: 524–531
Ballard PL, Ballard RA 1995 Scientific basis and therapeutic regimens for use of antenatal glucocorticoids. Am J Obstet Gynecol 173: 254–262
Davey DA, MacGillivray I 1988 The classification and definition of the hypertensive disorders of pregnancy. Am J Obstet Gynecol 158: 892–898
Wide-Swensson D, Montan S, Arulkumaran S, Ingemarsson I, Ratnam SS 1993 Effect of methyldopa and isradipine on fetal heart rate pattern assessed with computerized cardiotocography in human pregnancy. Am J Obstet Gynecol 169: 1581–1585
Kloosterman GJ 1970 On intrauterine growth, the significance of prenatal care. Int J Gyn Obstet 8: 895–912
Arduini D, Rizzo G 1990 Normal values of Pulsatility Index from fetal vessels: a cross-sectional study on 1556 healthy fetuses. J Perinat Med 18: 165–172
Dawes GS, Moulden M, Redman CW 1991 System 8000: computerized antenatal FHR analysis. J Perinat Med 19: 47–51
Kari MA, Hallman M, Eronen M, Teramo K, Virtanen M, Koivisto M, Ikonen RS 1994 Prenatal dexamethasone treatment in conjunction with rescue therapy of human surfactant: a randomized placebo-controlled multicenter study. Pediatrics 93: 730–736
Moïse AA, Wearden ME, Kozinetz CA, Gest AL, Welty SE, Hansen TN 1995 Antenatal steroids are associated with less need for blood pressure support in extremely premature infants. Pediatrics 95: 845–850
Derks JB, Giussani DA, Jenkins SL, Wentworth RA, Visser GH, Padbury JF, Nathanielsz PW 1997 A comparative study of cardiovascular, endocrine, and behavioural effects of betamethasone and dexamethasone administration to fetal sheep. J Physiol 499: 217–226
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
Koenen SV, Mecenas CA, Smith GS, Jenkins S, Nathanielsz PW 2002 Effects of maternal betamethasone administration on fetal and maternal blood pressure and heart rate in the baboon at 0.7 of gestation. Am J Obstet Gynecol 186: 812–817
Whitworth JA, Brown MA, Kelly JJ, Williamson PM 1995 Mechanisms of cortisol-induced hypertension in humans. Steroids 60: 76–80
Ullian ME 1999 The role of corticosteroids in the regulation of vascular tone. Cardiovasc Res 41: 55–64
de Kloet ER, Reul JM, Sutanto W 1990 Corticosteroids and the brain. J Steroid Biochem Mol Biol 37: 387–394
Mulder EJ, Koenen SV, Blom I, Visser GH 2004 The effects of antenatal betamethasone administration on fetal heart rate and behaviour depend on gestational age. Early Hum Dev 76: 65–77
Nijhuis IJ, ten Hof J, Mulder EJ, Nijhuis JG, Narayan H, Taylor D, Westers P, Visser GH 1998 Numerical fetal heart rate analysis: nomograms, minimal duration of recording and intrafetal consistency. Prenat Neonat Med 3: 314–322
Cohlen BJ, Stigter RH, Derks JB, Mulder EJ, Visser GH 1996 Absence of significant haemodynamic changes in the fetus following maternal betamethasone administration. Ultrasound Obstet Gynaecol 8: 252–255
Wallace EM, Baker LS 1999 Effect of antenatal betamethasone administration on placental vascular resistance. Lancet 353: 1404–1407
Acknowledgements
The authors thank G. Kortes-van Hoffen and M. Pomp for their valuable contributions to this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lunshof, M., Boer, K., Wolf, H. et al. Short-Term (0–48 h) Effects of Maternal Betamethasone Administration on Fetal Heart Rate and Its Variability. Pediatr Res 57, 545–549 (2005). https://doi.org/10.1203/01.PDR.0000155948.83570.EB
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1203/01.PDR.0000155948.83570.EB
This article is cited by
-
Increased right ventricular power and ductal characteristic impedance underpin higher pulmonary arterial blood flow after betamethasone therapy in fetal lambs
Pediatric Research (2018)
-
Effect of perinatal glucocorticoids on vascular health and disease
Pediatric Research (2017)
-
Retrospective analysis on the efficacy of corticosteroid prophylaxis prior to elective caesarean section to reduce neonatal respiratory complications at term of pregnancy: review of literature
Archives of Gynecology and Obstetrics (2013)
-
Fetal acid–base balance after betamethasone administration: relation to fetal heart rate variability
Archives of Gynecology and Obstetrics (2008)
