Ambulatory Blood Pressure Monitoring in Children and Adults Prenatally Exposed to Dexamethasone Treatment

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2022 Feb 11

PMID 35148399

Authors

Leif Karlsson

Lena Wallensteen

Anna Nordenstrom

Rafael T Krmar

Svetlana Lajic

Affiliations

Soon will be listed here.

Abstract

Context: The clinical use of dexamethasone (DEX) prenatally to reduce virilization of external genitalia in female fetuses with congenital adrenal hyperplasia (CAH) is efficient but still controversial. It remains challenging to prevent the excessive exposure of DEX in unborn healthy babies during the first trimester of pregnancy.

Objective: Since endogenous glucocorticoids contribute to the maintenance of blood pressure (BP) and since events during fetal life may program the fetus and affect future metabolic health, the aim of this study was to analyze ambulatory BP measurements in CAH-unaffected children and adults that were prenatally exposed to DEX treatment.

Methods: Ambulatory BP measurements were analyzed in 33 (16 female) DEX-treated participants aged 5.1 to 26.3 years (19 participants aged ≤ 18 years) and in 54 (28 female) age- and sex-matched apparently healthy controls aged 5.5 to 25.3 years (27 participants aged ≤ 18 years) with ambulatory normotension.

Results: Participants' age, height, weight, and body mass index were similar between the DEX-treated group and the control group. Heart rate, 24-hour BP, pulse pressure, and nighttime dipping did not statistically significantly differ between DEX-treated participants and controls.

Conclusion: Our study suggests that prenatal DEX treatment in CAH-unaffected children and adults does not appear to adversely affect ambulatory BP later in life. Our observations need to be confirmed in larger studies.

Citing Articles

An update on the long-term outcomes of prenatal dexamethasone treatment in congenital adrenal hyperplasia.

Vant Westeinde A, Karlsson L, Messina V, Wallensteen L, Brosamle M, Dal Maso G Endocr Connect. 2023; 12(4).

PMID: 36752813 PMC: 10083667. DOI: 10.1530/EC-22-0400.

Pregnancy and Prenatal Management of Congenital Adrenal Hyperplasia.

Cera G, Locantore P, Novizio R, Maggio E, Ramunno V, Corsello A J Clin Med. 2022; 11(20).

PMID: 36294476 PMC: 9605322. DOI: 10.3390/jcm11206156.

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