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Type: Journal article
Title: The influence of sex and antenatal betamethasone exposure on vasoconstrictors and the preterm microvasculature
Author: Stark, M.
Hodyl, N.
Wright, I.
Clifton, V.
Citation: The Journal of Maternal-Fetal and Neonatal Medicine, 2011; 24(10):1215-1220
Publisher: Informa Healthcare
Issue Date: 2011
ISSN: 1476-7058
Statement of
Michael J. Stark, Nicolette A. Hodyl, Ian M. R. Wright & Vicki Clifton
Abstract: Objective: Dysregulated vascular resistance contributes to hypotension following preterm birth with sex-specific differences in microvascular function conferring a male disadvantage. We hypothesized that glucocorticoid mediated, sex-specific differences in the endogenous catecholamine norepinephrine and endothelially derived endothelin-1 (ET-1) contribute to microvascular dysfunction in preterm neonates in the immediate newborn period. Methods: Umbilical and plasma ET-1 and normetanephrine, in 24 h urine samples, were determined at 24, 72, and 120 h of age in 24–34 week infants (n = 60). Microvascular blood flow was determined by laser Doppler flowmetry. Results: In infants born within 72 h of antenatal glucocorticoid exposure, normetanephrine was higher in females than males (p = 0.048). Normetanephrine was inversely correlated with both microvascular blood flow at 24 h (p = 0.025) and CRIB II (p = 0.001). While umbilical arterial ET-1 was higher in females delivered <72 h after antenatal betamethasone (p = 0.006), plasma ET-1 did not correlate with microvascular blood flow or illness severity. Only sex and normetanephrine contributed significantly to both microvascular blood flow and endothelium dependant vasodilatation. Conclusions: These data support glucocorticoid mediated, sex-specific differences in mediators of vascular tone that may contribute to the impaired mechanisms compromising successful hemodynamic adaption to neonatal life and resulting in excess male morbidity and mortality.
Keywords: Neonate; glucocorticoids; endothelin-1; normetanephrine; vascular tone
Rights: © 2011 Informa UK, Ltd.
DOI: 10.3109/14767058.2011.569618
Appears in Collections:Aurora harvest 2
Obstetrics and Gynaecology publications

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