Antenatal betamethasone administration alters stress physiology in healthy neonates

Obstet Gynecol. 2009 May;113(5):1082-1088. doi: 10.1097/AOG.0b013e3181a1f0e6.


Objective: To 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.

Methods: In 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.

Results: On 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.

Conclusion: A single course of antenatal betamethasone treatment induces a suppression of stress reactivity in healthy newborns.

Publication types

  • Controlled Clinical Trial

MeSH terms

  • Betamethasone / administration & dosage*
  • Case-Control Studies
  • Cortisone / metabolism
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Hydrocortisone / metabolism
  • Hypothalamo-Hypophyseal System / drug effects
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / chemically induced
  • Infant, Premature, Diseases / metabolism
  • Infant, Premature, Diseases / physiopathology*
  • Male
  • Pituitary-Adrenal System / drug effects
  • Pregnancy
  • Premature Birth / prevention & control
  • Prenatal Exposure Delayed Effects / chemically induced
  • Prenatal Exposure Delayed Effects / metabolism
  • Prenatal Exposure Delayed Effects / physiopathology*
  • Stress, Physiological / drug effects*
  • Stress, Physiological / physiology


  • Glucocorticoids
  • Betamethasone
  • Cortisone
  • Hydrocortisone