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Abstract
Healthy child development is under the influence of prenatal and perinatal exposure to stress stimuli. The aim of this study is to test the hypotheses that (1) neonates requiring catecholamine blood pressure support are more often born to mothers with stress-related cardiometabolic diseases, (2) maternal stress-related diseases are associated with more frequent requirement of maternal corticosteroid treatment and (3) antenatal steroid exposure of neonates reduces the need of postnatal catecholamine support. A retrospective cohort study was performed on a sample of 427 mature (13%), preterm (64%) and extremely preterm (23%) neonates of both sexes. Mothers at risk of preterm delivery were treated with dexamethasone. The blood pressure support in neonates was performed by intravenous treatment via umbilical or epicutaneous venous catheter with dopamine (5 ug/kg/min) or dobutamine (5 ug/kg/min) or a combination of both. The results showed a lack of association between maternal stress-related diseases and the complicated outcome of their neonates. Maternal treatment with corticosteroid dexamethasone was associated with lower frequency of catecholamine blood pressure support requirement. Catecholamine support was more needed in male infants. Thus, the occurrence of maternal cardiometabolic stress-related diseases does not appear to be related to the need of catecholamine support in the neonate. In agreement with the second hypothesis, a more frequent maternal corticosteroid treatment was associated with the presence of maternal stress-related diseases. Most importantly, the obtained results support the hypothesis on positive influence of maternal glucocorticoid administration on cardiovascular outcome of the neonate, representing an additional beneficial effect of antenatal corticosteroids.
Maternal hypertension, diabetes and obesity, which belong to cardiometabolic stress-related diseases, failed to show a negative influence on neonatal health as was determined by the need of catecholamine blood pressure support in a large sample of 427 immature and mature newborns. Since glucocorticoids are often viewed as negative agents that should be avoided, the important finding of the present study is the beneficial effect of maternal corticosteroid treatment on blood pressure stability of the neonate.
LAY SUMMARY
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The authors report no conflict of interest.
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Notes on contributors
Alexandra Garafova
Alexandra Garafova, MD, PhD is a physician of the Department of Neonatology, University Hospital, Bratislava. She is acting as a special assistent of the Institute of Pediatrics, Slovak Medical University, Bratislava. She has finished her PhD in normal and pathological physiology at the Faculty of Medicine of Comenius University. Her research is focused on stress and neuroendocrine relations mainly in clinical studies in humans.
Eva Kornanova
Eva Kornanova, MD is a trainee of the 1st Department of Obstetrics and Gynaecology, Faculty of Medicine, Comenius University in Bratislava. She is also a PhD student in gyneacology and obstetrics at the Faculty of Medicine of the Comenius University, Bratislava, Slovakia.
Darina Chovancova
Assoc. Prof. Darina Chovancova, MD, PhD is a superintendent of the Department of Neonatology, University Hospital, Bratislava and she is a specialist responsible for education in neonatology at the Slovak Medical University, Bratislava. She is the President of the Neonatology Panel of the Slovak Pediatric Association. Up to now, her research has been focused on diagnostics and treatment in neonatology.
Miroslav Borovsky
Prof. Miroslav Borovsky, MD, PhD is a superintendent of the 1st Department of Obstetrics and Gynaecology, Faculty of Medicine, Comenius University in Bratislava. He is the main expert of the Ministry of Health of the Slovak Republic for gynecology and obstetrics. In addition to these positions, he also holds many other presidential positions in the Section of Gynecological Endocrinology, Slovak Society for Endocrinology, Menopause and Andropause. His main subspecialization is gynecological endocrinology.
Peter Karailiev
Peter Karailiev, Dr rer. nat., is a PhD student at the Laboratory of Pharmacological Neuroendocrinology which is part of the Department of Endocrine Regulations and Psychopharmacology of the IEE BMC SAS under the supervision of Prof. Jezova. He has a master degree in molecular biology at the Faculty of Natural Sciences of Comenius University. His research is focused on molecular mechanisms and atypical markers of the stress response.
Natasa Hlavacova
Natasa Hlavacova, PhD. is a Head of the Department of Endocrine Regulations and Psychopharmacology at the Institute of Experimental Endocrinology of the Biomedical Research Center, SAS, Slovakia. She is a member of the Scientific Committee of the Biomedical Research Center, SAS. She is serving as an Editor of the General Physiology and Biophysics. She is expert in the field of Behavioral Neuroscience.
Daniela Jezova
Prof. Daniela Jezova, PharmD is a full professor of Pharmacology at the Faculty of Medicine of Comenius University and the Head of the Laboratory of Pharmacological Neuroendocrinology being a part of the Department of Endocrine Regulations and Psychopharmacology of the IEE BMC SAS, Slovakia. She has been a vice-president of the Slovak Academy of Sciences and vice-president of All European Academies. She is serving as an international expert in European research networks including the panel of European Research Council (ERC) on Endocrinology, Pathophysiology and Physiology. Her research team focused on stress research and psychopharmacology in both humans and animals belongs to the evaluated top research teams in Slovakia.