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1 Department of Pediatrics, Women and Infants Hospital of Rhode Island, Brown University School of Medicine, Providence, Rhode Island 02905; 2 Division of Service and Intervention Research, National Institute of Mental Health, Bethesda, Maryland 20892; and 3 Department of Surgery, State University of New York at Stony Brook, Stony Brook, New York 11794-8191
Antenatal corticosteroid therapy reduces
the incidence of intraventricular hemorrhage in premature infants.
Enhanced microvascular integrity might provide protection against
intraventricular hemorrhage. In the adult, there is evidence to suggest
that the blood-brain barrier may be under hormonal control. We
hypothesized that antenatal corticosteroids decrease blood-brain
barrier permeability in the preterm ovine fetus. Chronically
instrumented 120-day-gestation fetuses were studied 12 h after the last
of four 6-mg dexamethasone (n = 5) or
placebo (n = 6) injections had been
given over 48 h to the ewes. Blood-brain barrier function was
quantified with the blood-to-brain transfer constant
(Ki)
for 
-aminoisobutyric acid (AIB).
Ki was
significantly lower across brain regions in the fetuses of ewes that
received antenatal dexamethasone compared with placebo (ANOVA;
interaction, F = 2.54, P < 0.004). In fetuses of
dexamethasone- and placebo-treated ewes,
Ki
(µl · g brain
wt
1 · min1,
mean ± SD) was, respectively, 2.43 ± 0.27 vs. 3.41 ± 0.74 in the cortex, 4.46 ± 0.49 vs. 5.29 ± 0.85 in the cerebellum,
and 3.70 ± 0.49 vs. 5.11 ± 0.70 in the medulla. We
conclude that antenatal treatment with corticosteroids reduces
blood-brain permeability in the ovine fetus.
-aminoisobutyric acid; brain; corticosteroids; sheep
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