The Optimization of Antenatal Corticosteroid Therapy

Tsukasa Takahashi

doi:10.26182/dc4w-jc84

The Optimization of Antenatal Corticosteroid Therapy

Tsukasa Takahashi

UWA Medical School

Research output: Thesis › Doctoral Thesis

224 Downloads (Pure)

Abstract

Antenatal steroid (ANS) therapy greatly improves outcomes for preterm infants; when administered
judiciously, it accelerates fetal lung maturation, yielding reduced risk of neonatal death and serious
disease. However, recent data have identified increased ANS risks, including neurodevelopmental
abnormalities, highlighting the fact that dosing for ANS therapy has never been optimised. This thesis
details the findings of work to optimise ANS therapy, using the sheep model of pregnancy. Key
findings are that continuous, low amplitude betamethasone concentrations were key to accelerating
preterm lung maturation, and equated with extended duration of benefit and improved treatment
reliability.

Original language	English
Qualification	Doctor of Philosophy
Awarding Institution	The University of Western Australia
Supervisors/Advisors	Payne, Matt, Supervisor Kemp, Matthew, Supervisor Newnham, John, Supervisor Ireland, Demelza, Supervisor
Award date	2 Oct 2023
DOIs	https://doi.org/10.26182/dc4w-jc84
Publication status	Unpublished - 2023

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10.26182/dc4w-jc84

THESIS - DOCTOR OF PHILOSOPHY - TAKAHASHI Tsukasa - 2023
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LPCAT1 levels in the placenta, the maternal plasma and the fetal plasma do not predict fetal lung responses to glucocorticoids in a sheep model of pregnancy
Takahashi, T., Fee, E. L., Takahashi, Y., Usuda, H., Carter, S. W. D., Ikeda, H., Saito, M., Kumagai, Y., Bridges, J. P., Jobe, A. H., Choolani, M. A. & Kemp, M. W., Jul 2023, In: Placenta. 138, p. 1-9 9 p.
Research output: Contribution to journal › Article › peer-review
Betamethasone phosphate reduces the efficacy of antenatal steroid therapy and is associated with lower birth weights when administered to pregnant sheep in combination with betamethasone acetate
Takahashi, T., Fee, E. L., Takahashi, Y., Saito, M., Yaegashi, N., Usuda, H., Furfaro, L., Carter, S., Schmidt, A. F., Newnham, J. P., Jobe, A. H. & Kemp, M. W., Apr 2022, In: American Journal of Obstetrics and Gynecology. 226, 4, p. 564.e1-564.e14
Research output: Contribution to journal › Article › peer-review

Open Access
23 Link opens in a new tab Citations (Scopus)
Continuous but not pulsed low-dose fetal betamethasone exposures extend the durability of antenatal steroid therapy
Takahashi, T., Takahashi, Y., Fee, E. L., Saito, M., Yaegashi, N., Usuda, H., Bridges, J. P., Milad, M. A., Furfaro, L., Carter, S., Schmidt, A. F., Newnham, J. P., Jobe, A. H. & Kemp, M. W., 1 Jun 2022, In: American journal of physiology. Lung cellular and molecular physiology. 322, 6, p. L784-L793
Research output: Contribution to journal › Article › peer-review
8 Link opens in a new tab Citations (Scopus)

Cite this

@phdthesis{8bfff91c4df74683bfc9c94dc7470cec,

title = "The Optimization of Antenatal Corticosteroid Therapy",

abstract = "Antenatal steroid (ANS) therapy greatly improves outcomes for preterm infants; when administered judiciously, it accelerates fetal lung maturation, yielding reduced risk of neonatal death and serious disease. However, recent data have identified increased ANS risks, including neurodevelopmental abnormalities, highlighting the fact that dosing for ANS therapy has never been optimised. This thesis details the findings of work to optimise ANS therapy, using the sheep model of pregnancy. Key findings are that continuous, low amplitude betamethasone concentrations were key to accelerating preterm lung maturation, and equated with extended duration of benefit and improved treatment reliability.",

keywords = "Antenatal corticosteroids, betamethasone, preterm labor, lamb, surfactant protein, fetal lung, LPCAT1, non-responder",

author = "Tsukasa Takahashi",

year = "2023",

doi = "10.26182/dc4w-jc84",

language = "English",

school = "The University of Western Australia",

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PY - 2023

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N2 - Antenatal steroid (ANS) therapy greatly improves outcomes for preterm infants; when administered judiciously, it accelerates fetal lung maturation, yielding reduced risk of neonatal death and serious disease. However, recent data have identified increased ANS risks, including neurodevelopmental abnormalities, highlighting the fact that dosing for ANS therapy has never been optimised. This thesis details the findings of work to optimise ANS therapy, using the sheep model of pregnancy. Key findings are that continuous, low amplitude betamethasone concentrations were key to accelerating preterm lung maturation, and equated with extended duration of benefit and improved treatment reliability.

AB - Antenatal steroid (ANS) therapy greatly improves outcomes for preterm infants; when administered judiciously, it accelerates fetal lung maturation, yielding reduced risk of neonatal death and serious disease. However, recent data have identified increased ANS risks, including neurodevelopmental abnormalities, highlighting the fact that dosing for ANS therapy has never been optimised. This thesis details the findings of work to optimise ANS therapy, using the sheep model of pregnancy. Key findings are that continuous, low amplitude betamethasone concentrations were key to accelerating preterm lung maturation, and equated with extended duration of benefit and improved treatment reliability.

KW - Antenatal corticosteroids

KW - betamethasone

KW - preterm labor

KW - lamb

KW - surfactant protein

KW - fetal lung

KW - LPCAT1

KW - non-responder

U2 - 10.26182/dc4w-jc84

DO - 10.26182/dc4w-jc84

M3 - Doctoral Thesis

ER -

The Optimization of Antenatal Corticosteroid Therapy

Abstract

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Research output

LPCAT1 levels in the placenta, the maternal plasma and the fetal plasma do not predict fetal lung responses to glucocorticoids in a sheep model of pregnancy

Betamethasone phosphate reduces the efficacy of antenatal steroid therapy and is associated with lower birth weights when administered to pregnant sheep in combination with betamethasone acetate

Continuous but not pulsed low-dose fetal betamethasone exposures extend the durability of antenatal steroid therapy

Cite this