Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2010) 24 P4

BSPED2010 Poster Presentations (1) (59 abstracts)

Neonatal adrenal suppression from maternal steroid use: A retrospective case note study

S Ho , R Petkar , B Avatapalle & R Coombs


Department of Neonatal Intensive Care, Jessop Wing, Royal Hallamshire Hospital, Sheffield, UK.


Introduction: Infants born to mothers on antenatal steroid medication may develop adrenal suppression postnatally which can be potentially life-threatening. However, the incidence is unknown and screening for at risk infants is not universal.

Aim: The aim of our study was to review the outcome of infants born to mothers on antenatal steroids.

Method: We retrospectively reviewed our neonatal “paediatric alerts” for mothers on antenatal steroids between 2000 and 2009. Mothers on continuous oral steroid for >6 months before delivery were included in the study. Three cortisol levels were obtained at 8 hourly intervals on postnatal day 3. Adrenal suppression was defined as ≥2 levels of cortisol <100 nmol/l. All results are presented as mean±standard error of mean.

Results: Data were available for analysis in 50 appropriate patients. Nine (18%) patients had results consistent with adrenal insufficiency (mean cortisol 86±8.5 nmol/l). All 9 mothers were on prednisolone (mean daily dose 14±4 mg). Eight patients were started on replacement steroids. One (2%) patient on replacement steroids was admitted to hospital with adrenal crisis at 2 months old. All 8 patients on replacement steroids had normal synacthen test at 4 months old and steroids were stopped. Comparing patients with normal versus suppressed cortisol levels, mean maternal steroid dose (converted to prednisolone dose) was 16±2 and 14±4 mg respectively (P=0.70) and mean duration of maternal steroid therapy was 130±24 and 108±50 weeks respectively (P=0.70).

Conclusion: Adrenal suppression occurs in a significant proportion of infants born to mothers on antenatal steroids, independent of the duration or dose of maternal steroid therapy. Although this appears to be temporary, there is still a small risk of developing adrenal crisis. Screening for adrenal suppression postnatally is therefore recommended in infants at risk.

Volume 24

38th Meeting of the British Society for Paediatric Endocrinology and Diabetes

British Society for Paediatric Endocrinology and Diabetes 

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