Glucocorticoids and Preterm Hypoxic-Ischemic Brain Injury The Good and the Bad.pdfVIP

Hindawi Publishing Corporation Journal of Pregnancy Volume 2012, Article ID 751694, 9 pages doi:10.1155/2012/751694 Review Article Glucocorticoids and Preterm Hypoxic-Ischemic Brain Injury: The Good and the Bad Laura Bennet, Joanne O. Davidson, Miriam Koome, and Alistair Jan Gunn Fetal Physiology and Neuroscience Group, Department of Physiology, The University of Auckland, Auckland 1142, New Zealand Correspondence should be addressed to Laura Bennet, l.bennet@auckland.ac.nz Received 27 March 2012; Accepted 13 July 2012 Academic Editor: Janna Morrison Copyright © 2012 Laura Bennet et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Fetuses at risk of premature delivery are now routinely exposed to maternal treatment with synthetic glucocorticoids. In randomized clinical trials, these substantially reduce acute neonatal systemic morbidity, and mortality, after premature birth and reduce intraventricular hemorrhage. However, the overall neurodevelopmental impact is surprisingly unclear; worryingly, postnatal glucocorticoids are consistently associated with impaired brain development. We review the clinical and experimental evidence on how glucocorticoids may affect the developing brain and highlight the need for systematic research. 1. Introduction blood flow [ 13], alterations in neuronal activity [14], and brain growth retardation [ 15]. Since Liggins and Howie [1] showed that antenatal glu-