Multiple courses of betamethasone do not appear to decrease fetal adrenal steroidogenesis

Objective: The aim was to investigate prospectively whether there was a difference between the adrenal function of mothers and fetuses exposed to a single course of betamethasone compared to those pregnancies with repeated courses. Methods: All patients presenting in labor after receiving at least one course of betamethasone were eligible. Patients exposed to oral steroids during pregnancy were excluded. At delivery, a maternal venous sample and umbilical cord arterial blood were collected for evaluation. Maternal cortisol and fetal cortisol and dehydroeplandrosterone sulfate (DHEAS) were determined. A p value < 0.05 was considered significant. Results: Thirty-four mothers were enrolled in this prospective cohort study and 46 infants were delivered. The two groups were comparable except for the number of courses of betamethasone administered. Group A received one course (n = 17), while Group B received more than one course (n = 17). There was no significant difference in hormone levels between the groups: maternal cortisol 29.5 ± 5.4 g/dl versus 20.8 ± 4.3 g/dl, fetal cortisol 4.9 ± 0.9 g/dl versus 5.3 ± 0.9 g/dl, fetal DHEAS 154.4 ± 25 g/dl versus 142.4 ± 20.3 g/dl. Conclusion: Multiple courses of betamethasone did not appear to decrease maternal cortisol or fetal cortisol and DHEAS levels when compared to one course.