Can Placental Corticotropin-Releasing Hormone Inform Timing of Antenatal Corticosteroid Administration?

Publication Date

2-2019

Document Type

Article

Organizational Units

College of Arts Humanities and Social Sciences, Psychology

Keywords

Corticosteroids, Placental corticotropin-releasing hormone, Antenatal

Abstract

Context

Antenatal corticosteroids are commonly administered to pregnant women at risk for delivering between 23 and 34 gestational weeks; they provide crucial benefits to fetal lung maturation and reduce risk for neonatal morbidity and mortality. Corticosteroids are maximally efficacious for lung maturation when administered within 2 to 7 days of delivery. Accurately identifying the timing of preterm delivery is thus critical to ensure that antenatal corticosteroids are administered within a week of delivery and to avoid unnecessary administration to women who will deliver at term. A plausible biomarker for predicting time of delivery is placental corticotropin-releasing hormone (pCRH).

Objective

To assess whether pCRH concentrations predict time to delivery and specifically which women will deliver within a week of treatment.

Design

pCRH concentrations were evaluated before administration of the corticosteroid betamethasone, and timing of delivery was recorded.

Participants

A total of 121 women with singleton pregnancies who were prescribed betamethasone.

Results

Elevated pCRH concentrations were associated with a shorter time from treatment to delivery. Receiver-operating characteristic curves revealed that pCRH may improve the precision of predicting preterm delivery.

Conclusions

In the current sample, pCRH concentrations predicted the likelihood of delivering within 1 week of corticosteroid treatment. Current findings suggest that pCRH may be a diagnostic indicator of impending preterm delivery. Increasing the precision in predicting time to delivery could inform when to administer antenatal corticosteroids, thus maximizing benefits and reducing the likelihood of exposing fetuses who will be delivered at term.

Copyright Date

9-11-2018

Copyright Statement / License for Reuse

All Rights Reserved
All Rights Reserved.

Rights Holder

Endocrine Society

Provenance

Received from CHORUS

File Format

application/pdf

Language

English (eng)

Extent

8 pgs

File Size

257 KB

Publication Statement

Copyright is held by the Endocrine Society. User is responsible for all copyright compliance. This article was originally published as:

Swales, D. A., Grande, L. A., Wing, D. A., Edelmann, M., Glynn, L. M, Sandman, C., . . ., & Davis, E. P. (2019). Can placental corticotropin-releasing hormone inform timing of antenatal corticosteroid administration? The Journal of Clinical Endocrinology and Metabolism, 104(2), 443-450. https://doi.org/10.1210/jc.2018-00956

Publication Title

The Journal of Clinical Endocrinology and Metabolism

Volume

104

Issue

2

First Page

443

Last Page

450

ISSN

1945-7197

PubMed ID

30215731

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