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Evidence for adverse effect of perinatal glucocorticoid use on the developing brain

The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumf...

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Autor principal: Chang, Young Pyo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Pediatric Society 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000755/
https://www.ncbi.nlm.nih.gov/pubmed/24778691
http://dx.doi.org/10.3345/kjp.2014.57.3.101
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author Chang, Young Pyo
author_facet Chang, Young Pyo
author_sort Chang, Young Pyo
collection PubMed
description The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined.
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spelling pubmed-40007552014-04-28 Evidence for adverse effect of perinatal glucocorticoid use on the developing brain Chang, Young Pyo Korean J Pediatr Review Article The use of glucocorticoids (GCs) in the perinatal period is suspected of being associated with adverse effects on long-term neurodevelopmental outcomes for preterm infants. Repeated administration of antenatal GCs to mothers at risk of preterm birth may adversely affect fetal growth and head circumference. Fetal exposure to excess GCs during critical periods of brain development may profoundly modify the limbic system (primarily the hippocampus), resulting in long-term effects on cognition, behavior, memory, co-ordination of the autonomic nervous system, and regulation of the endocrine system later in adult life. Postnatal GC treatment for chronic lung disease in premature infants, particularly involving the use of dexamethasone, has been shown to induce neurodevelopmental impairment and increases the risk of cerebral palsy. In contrast to studies involving postnatal dexamethasone, long-term follow-up studies for hydrocortisone therapy have not revealed adverse effects on neurodevelopmental outcomes. In experimental studies on animals, GCs has been shown to impair neurogenesis, and induce neuronal apoptosis in the immature brains of newborn animals. A recent study has demonstrated that dexamethasone-induced hypomyelination may result from the apoptotic degeneration of oligodendrocyte progenitors in the immature brain. Thus, based on clinical and experimental studies, there is enough evidence to advice caution regarding the use of GCs in the perinatal period; and moreover, the potential long-term effects of GCs on brain development need to be determined. The Korean Pediatric Society 2014-03 2014-03-31 /pmc/articles/PMC4000755/ /pubmed/24778691 http://dx.doi.org/10.3345/kjp.2014.57.3.101 Text en Copyright © 2014 by The Korean Pediatric Society http://creativecommons.org/licenses/by-nc/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Chang, Young Pyo
Evidence for adverse effect of perinatal glucocorticoid use on the developing brain
title Evidence for adverse effect of perinatal glucocorticoid use on the developing brain
title_full Evidence for adverse effect of perinatal glucocorticoid use on the developing brain
title_fullStr Evidence for adverse effect of perinatal glucocorticoid use on the developing brain
title_full_unstemmed Evidence for adverse effect of perinatal glucocorticoid use on the developing brain
title_short Evidence for adverse effect of perinatal glucocorticoid use on the developing brain
title_sort evidence for adverse effect of perinatal glucocorticoid use on the developing brain
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000755/
https://www.ncbi.nlm.nih.gov/pubmed/24778691
http://dx.doi.org/10.3345/kjp.2014.57.3.101
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