Bone metabolism in pregnant women exposed to single compared with multiple courses of corticosteroids

Alex C. Vidaeff, Mary A. Carroll, Lisa Mele, Ronald J. Wapner, Brian Mercer, Alan M. Peaceman, Yoram Sorokin, Donald J. Dudley, Catherine Y. Spong, Kenneth J. Leveno, Margaret Harper, Steve N. Caritis, Menachem Miodovnik, John M. Thorp, Atef Moawad, Mary J. O'Sullivan, Marshall W. Carpenter, Dwight J. Rouse, Baha Sibai

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVE:: To compare markers of maternal bone metabolism between women who received a single compared with multiple courses of antenatal corticosteroids. METHODS:: This is an analysis of serum samples from a previously reported randomized, placebo-controlled, multicenter trial. Women at risk for preterm delivery after an initial course of corticosteroids were randomly assigned to weekly courses of betamethasone (active) or placebo. Serum levels of carboxy terminal propeptide of type I procollagen (PICP) and cross-linked carboxy terminal telopeptide of type I collagen (ICTP) were measured to assess the rate of bone formation and resorption, respectively, at three time points. The placebo group (n=93) was compared with the active group, receiving four or more courses of betamethasone (n=112). RESULTS:: There were significant (P<.001) increases in PICP and ICTP between baseline and delivery in both groups. Cross-linked carboxy terminal telopeptide of type I collagen, but not PICP, was lower with corticosteroid exposure immediately before administration of the fourth study course (P<.001). No significant differences in PICP and ICTP were seen between groups at delivery. CONCLUSION:: Increasing levels of PICP and ICTP with advancing gestation are consistent with physiologic changes in maternal bone metabolism. Multiple courses of corticosteroids for fetal maturation are not associated with persistent or cumulative effects on maternal bone metabolism as measured by PICP and ICTP.

Original languageEnglish
Pages (from-to)1352-1358
Number of pages7
JournalObstetrics and Gynecology
Volume111
Issue number6
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

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Pregnant Women
Adrenal Cortex Hormones
Bone and Bones
Collagen Type I
Betamethasone
Placebos
Mothers
Bone Resorption
Serum
Osteogenesis
Multicenter Studies
procollagen type I carboxy terminal peptide
Pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Vidaeff, A. C., Carroll, M. A., Mele, L., Wapner, R. J., Mercer, B., Peaceman, A. M., ... Sibai, B. (2008). Bone metabolism in pregnant women exposed to single compared with multiple courses of corticosteroids. Obstetrics and Gynecology, 111(6), 1352-1358. https://doi.org/10.1097/AOG.0b013e318173573b

Bone metabolism in pregnant women exposed to single compared with multiple courses of corticosteroids. / Vidaeff, Alex C.; Carroll, Mary A.; Mele, Lisa; Wapner, Ronald J.; Mercer, Brian; Peaceman, Alan M.; Sorokin, Yoram; Dudley, Donald J.; Spong, Catherine Y.; Leveno, Kenneth J.; Harper, Margaret; Caritis, Steve N.; Miodovnik, Menachem; Thorp, John M.; Moawad, Atef; O'Sullivan, Mary J.; Carpenter, Marshall W.; Rouse, Dwight J.; Sibai, Baha.

In: Obstetrics and Gynecology, Vol. 111, No. 6, 01.06.2008, p. 1352-1358.

Research output: Contribution to journalArticle

Vidaeff, AC, Carroll, MA, Mele, L, Wapner, RJ, Mercer, B, Peaceman, AM, Sorokin, Y, Dudley, DJ, Spong, CY, Leveno, KJ, Harper, M, Caritis, SN, Miodovnik, M, Thorp, JM, Moawad, A, O'Sullivan, MJ, Carpenter, MW, Rouse, DJ & Sibai, B 2008, 'Bone metabolism in pregnant women exposed to single compared with multiple courses of corticosteroids', Obstetrics and Gynecology, vol. 111, no. 6, pp. 1352-1358. https://doi.org/10.1097/AOG.0b013e318173573b
Vidaeff, Alex C. ; Carroll, Mary A. ; Mele, Lisa ; Wapner, Ronald J. ; Mercer, Brian ; Peaceman, Alan M. ; Sorokin, Yoram ; Dudley, Donald J. ; Spong, Catherine Y. ; Leveno, Kenneth J. ; Harper, Margaret ; Caritis, Steve N. ; Miodovnik, Menachem ; Thorp, John M. ; Moawad, Atef ; O'Sullivan, Mary J. ; Carpenter, Marshall W. ; Rouse, Dwight J. ; Sibai, Baha. / Bone metabolism in pregnant women exposed to single compared with multiple courses of corticosteroids. In: Obstetrics and Gynecology. 2008 ; Vol. 111, No. 6. pp. 1352-1358.
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AU - Carroll, Mary A.

AU - Mele, Lisa

AU - Wapner, Ronald J.

AU - Mercer, Brian

AU - Peaceman, Alan M.

AU - Sorokin, Yoram

AU - Dudley, Donald J.

AU - Spong, Catherine Y.

AU - Leveno, Kenneth J.

AU - Harper, Margaret

AU - Caritis, Steve N.

AU - Miodovnik, Menachem

AU - Thorp, John M.

AU - Moawad, Atef

AU - O'Sullivan, Mary J.

AU - Carpenter, Marshall W.

AU - Rouse, Dwight J.

AU - Sibai, Baha

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N2 - OBJECTIVE:: To compare markers of maternal bone metabolism between women who received a single compared with multiple courses of antenatal corticosteroids. METHODS:: This is an analysis of serum samples from a previously reported randomized, placebo-controlled, multicenter trial. Women at risk for preterm delivery after an initial course of corticosteroids were randomly assigned to weekly courses of betamethasone (active) or placebo. Serum levels of carboxy terminal propeptide of type I procollagen (PICP) and cross-linked carboxy terminal telopeptide of type I collagen (ICTP) were measured to assess the rate of bone formation and resorption, respectively, at three time points. The placebo group (n=93) was compared with the active group, receiving four or more courses of betamethasone (n=112). RESULTS:: There were significant (P<.001) increases in PICP and ICTP between baseline and delivery in both groups. Cross-linked carboxy terminal telopeptide of type I collagen, but not PICP, was lower with corticosteroid exposure immediately before administration of the fourth study course (P<.001). No significant differences in PICP and ICTP were seen between groups at delivery. CONCLUSION:: Increasing levels of PICP and ICTP with advancing gestation are consistent with physiologic changes in maternal bone metabolism. Multiple courses of corticosteroids for fetal maturation are not associated with persistent or cumulative effects on maternal bone metabolism as measured by PICP and ICTP.

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