Antenatal dexamethasone treatment decreases plasma catecholamine levels in preterm infants

Pediatr Res. 1998 Jun;43(6):801-7. doi: 10.1203/00006450-199806000-00014.


Antenatal corticosteroid therapy (ACT) has many beneficial effects on preterm infants. The cellular mechanisms of action of ACT include beta-adrenergic receptor-mediated cAMP generation. This study investigated the effects of ACT on sympathoadrenal mechanisms during immediate postnatal adaptation of preterm infants. Plasma epinephrine, norepinephrine, 3,4-dihydroxyphenylglycol, and cAMP were measured within 12 h after birth in 103 preterm infants (gestational age 24-36 wk), who were divided into two groups (non-ACT and ACT group) according to whether the mother had received dexamethasone treatment. Infants in the ACT group had significantly lower concentrations of plasma catecholamines than infants in the non-ACT group; plasma epinephrine was 38% lower, and plasma norepinephrine was 20-40% lower in the ACT group, depending on gestational age (r = -0.37 in the non-ACT group and r = -0.28 in the ACT group, p < 0.05). Plasma cAMP concentrations were similar in the two groups. Antihypertensive treatment of the mother was associated with low plasma cAMP (p < 0.001), whereas tocolytic treatment was associated with high plasma cAMP (p = 0.001) of the infant. The results indicate that ACT attenuates the birth-related increase in plasma catecholamines. Still, plasma cAMP levels remain high, which suggests enhanced beta-adrenoceptor signaling after ACT.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Birth Weight
  • Cyclic AMP / blood
  • Delivery, Obstetric
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Epinephrine / blood*
  • Female
  • Gestational Age
  • Humans
  • Hypertension / drug therapy
  • Infant, Newborn
  • Infant, Premature / blood*
  • Male
  • Methoxyhydroxyphenylglycol / analogs & derivatives
  • Methoxyhydroxyphenylglycol / blood
  • Norepinephrine / blood*
  • Pregnancy
  • Pregnancy Complications, Cardiovascular / drug therapy
  • Prenatal Care
  • Regression Analysis
  • Respiratory Distress Syndrome, Newborn / prevention & control*
  • Tocolytic Agents / therapeutic use


  • Antihypertensive Agents
  • Tocolytic Agents
  • Methoxyhydroxyphenylglycol
  • Dexamethasone
  • Cyclic AMP
  • 3,4-dihydroxyphenylglycol
  • Norepinephrine
  • Epinephrine