Objective: To determine if one course of antenatal corticosteroids at 32 weeks produces maternal adrenal suppression at term. Methods: The adrenocorticotropic hormone (ACTH) stimulation test was administered at 38 weeks to 11 pregnant women who had received a single course of antenatal betamethasone prior to 33 weeks and to six control subjects. Results: There was no difference in basal cortisol levels (mean ± standard deviation) between the two groups: 41.6 ± 6.9 μg/dl for controls versus 36.0 ± 7.8 μg/dl for the steroid group, p = 0.16. Peak cortisol levels at 45 min following ACTH stimulation were not different: 61.6 ± 3.5 μg/dl for controls versus 55.0 ± 2.6 μg/dl for the steroid group, p = 0.16. The power of the study to detect a statistical difference in the observed peak cortisol levels was greater than 95%. None of the study subjects had laboratory criteria or clinical signs of adrenal suppression. Conclusions: A single course of betamethasone for women at risk for preterm delivery does not produce adrenal insufficiency at term and stress dose steroids are not recommended.
Bibliographical noteFunding Information:
Funding for this project was provided by a Wright State University Seed Grant, and by the Ohio State University General Clinical Research Center (NIH M01RR00034). The opinions and conclusions in this paper are those of the authors and are not intended to represent the official position of the Department of Defense, United States Air Force or Army, or any other government agency.