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. 2000 Sep;83(2):F112–F116. doi: 10.1136/fn.83.2.F112

Influence of antenatal steroids and sex on maturation of the epidermal barrier in the preterm infant

A Jain, N Rutter, P Cartlidge
PMCID: PMC1721153  PMID: 10952704

Abstract

BACKGROUND—The epidermal barrier is well developed in term infants but defective in the immature infant with important clinical consequences. The development of the barrier shares similarities with production of pulmonary surfactant. Studies in the rat have shown that barrier maturation is accelerated by antenatal steroids, both structurally and functionally. Females have a more mature barrier than males at the same gestational age. These factors have not been studied in the human.
AIM—To examine the influence of antenatal steroids and sex on maturation of the epidermal barrier in the preterm infant.
SUBJECTS—A total of 137 infants born before 34 weeks gestation, 80 boys and 57 girls, were studied: 87 had been exposed to antenatal steroids, and 50 had not; 99 were studied prospectively, and 38had been studied previously.
METHOD—Barrier function was measured as transepidermal water loss from abdominal skin by evaporimetry. Measurements were made within the first 48 hours and corrected to a standard relative humidity of 50% (TEWL50).
RESULTS—The relation between TEWL50 and gestation was exponential with very high levels in the most immature infants. No influence of antenatal steroids or sex could be shown. When infants who were optimally exposed to antenatal steroids were considered alone, no effect could be shown.
CONCLUSION—Epidermal maturation in the preterm infant does not appear to be influenced by antenatal steroids or sex, suggesting that the mechanism of maturation differs from that of the rat.


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Selected References

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  1. Agren J., Sjörs G., Sedin G. Transepidermal water loss in infants born at 24 and 25 weeks of gestation. Acta Paediatr. 1998 Nov;87(11):1185–1190. doi: 10.1080/080352598750031194. [DOI] [PubMed] [Google Scholar]
  2. Aszterbaum M., Feingold K. R., Menon G. K., Williams M. L. Glucocorticoids accelerate fetal maturation of the epidermal permeability barrier in the rat. J Clin Invest. 1993 Jun;91(6):2703–2708. doi: 10.1172/JCI116509. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Aszterbaum M., Menon G. K., Feingold K. R., Williams M. L. Ontogeny of the epidermal barrier to water loss in the rat: correlation of function with stratum corneum structure and lipid content. Pediatr Res. 1992 Apr;31(4 Pt 1):308–317. doi: 10.1203/00006450-199204000-00002. [DOI] [PubMed] [Google Scholar]
  4. Baum M., Quigley R. Prenatal glucocorticoids stimulate neonatal juxtamedullary proximal convoluted tubule acidification. Am J Physiol. 1991 Nov;261(5 Pt 2):F746–F752. doi: 10.1152/ajprenal.1991.261.5.F746. [DOI] [PubMed] [Google Scholar]
  5. Celsi G., Wang Z. M., Akusjärvi G., Aperia A. Sensitive periods for glucocorticoids' regulation of Na+,K(+)-ATPase mRNA in the developing lung and kidney. Pediatr Res. 1993 Jan;33(1):5–9. doi: 10.1203/00006450-199301000-00002. [DOI] [PubMed] [Google Scholar]
  6. Crowley P., Chalmers I., Keirse M. J. The effects of corticosteroid administration before preterm delivery: an overview of the evidence from controlled trials. Br J Obstet Gynaecol. 1990 Jan;97(1):11–25. doi: 10.1111/j.1471-0528.1990.tb01711.x. [DOI] [PubMed] [Google Scholar]
  7. Dodic M., Wintour E. M. Effects of prolonged (48 h) infusion of cortisol on blood pressure, renal function and fetal fluids in the immature ovine foetus. Clin Exp Pharmacol Physiol. 1994 Dec;21(12):971–980. doi: 10.1111/j.1440-1681.1994.tb02659.x. [DOI] [PubMed] [Google Scholar]
  8. Elias P. M., Menon G. K. Structural and lipid biochemical correlates of the epidermal permeability barrier. Adv Lipid Res. 1991;24:1–26. doi: 10.1016/b978-0-12-024924-4.50005-5. [DOI] [PubMed] [Google Scholar]
  9. Evans N. J., Rutter N. Development of the epidermis in the newborn. Biol Neonate. 1986;49(2):74–80. doi: 10.1159/000242513. [DOI] [PubMed] [Google Scholar]
  10. Hammarl-nd K., Nilsson G. E., Oberg P. A., Sedin G. Transepidermal water loss in newborn infants. I. Relation to ambient humidity and site of measurement and estimation of total transepidermal water loss. Acta Paediatr Scand. 1977 Sep;66(5):553–562. doi: 10.1111/j.1651-2227.1977.tb07946.x. [DOI] [PubMed] [Google Scholar]
  11. Hammarlund K., Sedin G., Strömberg B. Transepidermal water loss in newborn infants. VII. Relation to post-natal age in very pre-term and full-term appropriate for gestational age infants. Acta Paediatr Scand. 1982 May;71(3):369–374. doi: 10.1111/j.1651-2227.1982.tb09436.x. [DOI] [PubMed] [Google Scholar]
  12. Hammarlund K., Sedin G. Transepidermal water loss in newborn infants. III. Relation to gestational age. Acta Paediatr Scand. 1979 Nov;68(6):795–801. doi: 10.1111/j.1651-2227.1979.tb08214.x. [DOI] [PubMed] [Google Scholar]
  13. Hanley K., Rassner U., Jiang Y., Vansomphone D., Crumrine D., Komüves L., Elias P. M., Feingold K. R., Williams M. L. Hormonal basis for the gender difference in epidermal barrier formation in the fetal rat. Acceleration by estrogen and delay by testosterone. J Clin Invest. 1996 Jun 1;97(11):2576–2584. doi: 10.1172/JCI118706. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Holbrook K. A. Human epidermal embryogenesis. Int J Dermatol. 1979 Jun;18(5):329–356. doi: 10.1111/ijd.1979.18.5.329. [DOI] [PubMed] [Google Scholar]
  15. Khosla S. S., Smith G. J., Parks P. A., Rooney S. A. Effects of estrogen on fetal rabbit lung maturation: morphological and biochemical studies. Pediatr Res. 1981 Sep;15(9):1274–1281. doi: 10.1203/00006450-198109000-00010. [DOI] [PubMed] [Google Scholar]
  16. Khoury M. J., Marks J. S., McCarthy B. J., Zaro S. M. Factors affecting the sex differential in neonatal mortality: the role of respiratory distress syndrome. Am J Obstet Gynecol. 1985 Mar 15;151(6):777–782. doi: 10.1016/0002-9378(85)90518-6. [DOI] [PubMed] [Google Scholar]
  17. La Pine T. R., Jackson J. C., Bennett F. C. Outcome of infants weighing less than 800 grams at birth: 15 years' experience. Pediatrics. 1995 Sep;96(3 Pt 1):479–483. [PubMed] [Google Scholar]
  18. Nielsen H. C., Zinman H. M., Torday J. S. Dihydrotestosterone inhibits fetal rabbit pulmonary surfactant production. J Clin Invest. 1982 Mar;69(3):611–616. doi: 10.1172/JCI110488. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Nilsson G. E. Measurement of water exchange through skin. Med Biol Eng Comput. 1977 May;15(3):209–218. doi: 10.1007/BF02441040. [DOI] [PubMed] [Google Scholar]
  20. Okah F. A., Pickens W. L., Hoath S. B. Effect of prenatal steroids on skin surface hydrophobicity in the premature rat. Pediatr Res. 1995 Apr;37(4 Pt 1):402–408. doi: 10.1203/00006450-199504000-00004. [DOI] [PubMed] [Google Scholar]
  21. Rutter N., Hull D. Water loss from the skin of term and preterm babies. Arch Dis Child. 1979 Nov;54(11):858–868. doi: 10.1136/adc.54.11.858. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Rutter N. Percutaneous drug absorption in the newborn: hazards and uses. Clin Perinatol. 1987 Dec;14(4):911–930. [PubMed] [Google Scholar]
  23. Torday J. S. Androgens delay human fetal lung maturation in vitro. Endocrinology. 1990 Jun;126(6):3240–3244. doi: 10.1210/endo-126-6-3240. [DOI] [PubMed] [Google Scholar]
  24. Trahair J. F., Perry R. A., Silver M., Robinson P. M. Studies on the maturation of the small intestine in the fetal sheep. II. The effects of exogenous cortisol. Q J Exp Physiol. 1987 Jan;72(1):71–79. doi: 10.1113/expphysiol.1987.sp003056. [DOI] [PubMed] [Google Scholar]

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