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Departments of 1 Pediatrics and 2 Surgery and the Cardiovascular Center, University of Iowa, Iowa City, Iowa 52242
Studies were performed to test the
hypothesis that the absence of adrenal glucocorticoids late in
gestation alters sympathetic and baroreflex responses before and
immediately after birth. Fetal sheep at 130-131 days gestation
(term 145 days) were subjected to bilateral adrenalectomy before the
normal prepartum increase in plasma cortisol levels. One group of
fetuses (n = 5) received physiological cortisol
replacement with a continuous infusion of hydrocortisone (2 mg · day
1 · kg
1 for 10 days), whereas the other group received 0.9% NaCl vehicle (n = 5). All animals underwent a second surgery 48 h before the study for placement of a renal nerve recording electrode.
Heart rate (HR), mean arterial blood pressure (MABP), renal sympathetic nerve activity (RSNA), and baroreflex control of HR and RSNA were studied before and after cesarean section delivery. At the time of
study (140-141 days gestation), fetal plasma cortisol
concentration was undetectable in adrenalectomized (ADX) fetuses and
58 ± 9 ng/ml in animals receiving cortisol replacement (ADX + F). Fetal and newborn MABP was significantly greater in ADX + F
relative to ADX animals. One hour after delivery, MABP increased
13 ± 3 mmHg and RSNA increased 91 ± 12% above fetal values
in ADX + F (both P < 0.05) but remained unchanged
in ADX lambs. The midpoint pressures of the fetal HR and RSNA
baroreflex function curves were significantly greater in ADX + F
(54 ± 3 and 56 ± 3 mmHg for HR and RSNA curves,
respectively) than ADX fetuses (45 ± 2 and 46 ± 3 mmHg).
After delivery, the baroreflex curves reset toward higher pressure in
ADX + F but not ADX lambs. These results suggest that adrenal
glucocorticoids contribute to cardiovascular regulation in the
late-gestation fetus and newborn by modulating arterial baroreflex
function and sympathetic activity.
cardiovascular; glucocorticoids; newborn; renal sympathetic nerve activity
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