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Volume 16, Number 12,
Issue of June 15, 1996
pp. 3943-3949
Copyright ©1996 Society for Neuroscience
Maternal Glucocorticoid Secretion Mediates Long-Term Effects of
Prenatal Stress
Arnaud Barbazanges,
Pier Vincenzo Piazza,
Michel Le Moal, and
Stefania Maccari
Psychobiologie des Comportements Adaptatifs, INSERM U259,
Université de Bordeaux II, Domaine de Carreire, 33077 Bordeaux
Cedex, France
ABSTRACT
INTRODUCTION
MATERIALS AND METHODS
RESULTS
DISCUSSION
FOOTNOTES
REFERENCES
ABSTRACT
There is growing evidence that stressors occurring during pregnancy
can impair biological and behavioral adaptation to stress in the adult
offspring. Mechanisms by which stress in the pregnant rat can influence
development of the offspring are still unknown. In the present study,
we investigated the involvement of maternal corticosterone secretion
during pregnancy on the hypothalamo-pituitary-adrenal axis activity
of adult offspring. We investigated stress-induced corticosterone
secretion and hippocampal type I and type II corticosteroid receptors
in male adult rats submitted to prenatal stress born to either mothers
with intact corticosterone secretion or mothers in which stress-induced
corticosterone secretion was blocked by adrenalectomy with substitutive
corticosterone therapy. Repeated restraint during the last week of
pregnancy was used as prenatal stressor. Furthermore, the specific role
of an injection of corticosterone before the restraint stress on
adrenalectomized mothers with substitutive corticosterone treatment was
also studied. We report here that blockade of the mother's
stress-induced glucocorticoid secretion suppresses the prolonged
stress-induced corticosteroid response and the decrease in type I
hippocampal corticosteroid receptors usually observed in prenatally
stressed adults. Conversely, corticosterone administered during stress,
to mothers in which corticosterone secretion is blocked, reinstates the
effects of prenatal stress. These results suggest for the first time
that stress-induced increases in maternal glucocorticoids may be a
mechanism by which prenatal stress impairs the development of the adult
offspring's glucocorticoid response.
Key words:
corticosterone;
corticosteroid receptors;
hippocampus;
prenatal stress;
maternal environment;
development
INTRODUCTION
Prenatal environments exert profound influences on
the development of an organism and can predispose it to adaptive
disturbances in later life. In particular, in man, prenatal stress can
induce mental retardation and sleep disturbances in the infant (Stott,
1973 ; Shell, 1981 ). In animals, dams stressed during pregnancy can bear
offspring with reduced male sexual activity, enhanced emotional
reactivity (Thompson, 1957 ; Ward and Weisz, 1984 ; Weinstock et al.,
1988), and an increased propensity to self-administer drugs
(Deminière et al., 1992 ). Stress during pregnancy sensitizes
different neuroendocrine systems, such as gonadal axis (Ward, 1972 ) and
hypothalamo-pituitary-adrenal (HPA) axis, increasing stress-induced
corticosterone secretion in preweaning rats (Peters, 1982 ; Takahashi et
al., 1988 ; Henry et al., 1994 ) and prolonging stress-induced
corticosterone secretion in the adult (Fride et al., 1986 ; Maccari et
al., 1995 ). Prenatal stress also decreases the number of hippocampal
corticosteroid receptors (Maccari et al., 1995 ), which are the
principal substrate of the negative feedback control of glucocorticoid
secretion. Thus, a decrease in these corticosteroid receptors is
accompanied by increased glucocorticoid secretion and vice versa. Two
different cytosolic receptors contribute to this control: (1) the type
I, or mineralocorticoid receptor; and (2) the type II, or
glucocorticoid receptor (McEwen et al., 1986 ; De Kloet and Reul, 1987 ).
In the adult, it has been shown that HPA axis disturbances are related
to behavioral pathologies and early aging of cognitive performances
(Sapolsky et al., 1986 ; Holsboer, 1989 ; Piazza et al., 1991 ).
In the present study, we addressed the following question: what are the
pathophysiological mechanisms by which stress in the mother reaches the
fetus and influences its development? One putative cause, in
utero exposure to abnormally high levels of maternal
glucocorticoids, seems to be a good candidate: (1) corticosterone
secretion is one of the principal biological responses to stress
(Selye, 1956 ); (2) glucocorticoids are very liposoluble and easily
cross placental and blood-brain barriers (Zarrow et al., 1970 ); and
(3) exposure in utero to high levels of synthetic
glucocorticoids can have neurotoxic effects on monkey and human brain
(Epstein et al., 1977 ; Reinisch et al., 1978 ) or rat fetal brain (Uno
et al., 1990 ) and elevate systolic blood pressure in adult offspring
(Benediktsson et al., 1993 ).
To test this hypothesis, we studied the effects of blocking
maternal corticosterone secretion during the prenatal stress on the
stress-induced corticosterone secretion and hippocampal corticosteroid
receptors of adult offspring. Repeated restraint of the mother during
the last week of pregnancy was used as prenatal stressors, and an
adrenalectomy of the mother with a corticosterone-substitutive
treatment was used to block the increase in corticosterone secretion
induced by the restraint stress. Hippocampal corticosteroid receptors
were determined, as the binding capacity of these receptors appears to
be a principal regulating factor in corticosterone secretion
(McEwen et al., 1986 ; De Kloet and Reul, 1987 ). Furthermore, the
specific role of an injection of corticosterone on stressed mothers
adrenalectomized with corticosterone-substitutive
treatment was also studied on these same parameters in adult
offspring.
Table 1.
Plasma corticosterone concentrations after restraint stress
in pregnant rats
| Time post stress
(min) |
Day 1 |
Plasma corticosterone (µg/100
ml)
|
Blocked + corticosterone |
| Intact |
| Day 5 |
Day
7 |
Day 1 |
Day 5 |
|
| 30 min |
58.6
± 3.8 |
74.1 ± 7.5 |
59.9 ± 4.2 |
82.9
± 13.0 |
95.5 ± 23.5 |
| 105 min |
42.7 ± 3.7* |
33.4
± 10.7* |
25.2 ± 7.6* |
33.0 ± 1.6* |
9.6
± 1.9*# |
|
|
*p < 0.05 105 vs 30 min; #p < 0.01 day 5 vs day 1.
|
|
Our results show that the impairment induced by prenatal stress on the
activity of the HPA axis of adult offspring depends on high levels of
maternal corticosterone secretion during restraint stress. In fact,
blocking stress-induced corticosterone secretion by adrenalectomy with
corticosterone-substitutive treatment suppresses the prolonged
stress-induced corticosterone response and the reduced type I
hippocampal corticosteroid receptors observed in prenatally stressed
adults. Furthermore, the administration of corticosterone to these
mothers reinstates the effects induced by the prenatal stress.
MATERIALS AND METHODS
General methods
Subjects. Virgin female Wistar rats weighing 250 gm
were housed for 5 d in the presence of a sexually experienced Wistar
male weighing 450-500 gm. Pregnant females were individually housed
with ad libitum access to food and water in a constant light/dark cycle
(light on at 6 hr, off at 20 hr), and temperature (22°C) and humidity
(60%) were kept constant.
Prenatal stress. During the last week of pregnancy, pregnant
females in the stress group were placed for 45 min in a transparent
plastic cylinder in a lighted environment three times per day (9 A.M.,
12 A.M., and 5 P.M.). This stress procedure, described by Ward and
Weisz (1984) , was chosen because it has an indirect influence on the
fetus via a direct stress on the mother. Control female rats were left
undisturbed in their home cages. Only litters containing 10-14 pups
were selected for this study to eliminate extra stressors such as the
removal of pups. The offspring were weaned 21 d after birth, and 1-3
male siblings were taken from each litter. The number of litters
represented in each group was 5-10. At the time of weaning, the sex of
the pups was also checked, and only litters containing a similar number
of females and males were selected. Animals were tested at 90 d of
age.
Adrenalectomy and substitutive treatment. For this purpose,
females at 13 d of pregnancy were adrenalectomized (between 9 A.M. and
12 A.M.) via the dorsal approach and implanted subcutaneously, ~2 cm
rostral to the skin incision, with a 100 mg corticosterone pellet
(containing 50% corticosterone 21-hemisuccinate and 50% cholesterol),
which provides stable basal levels of the hormone (Meyer et al., 1979 ).
The adrenalectomy was performed under ether anesthesia. Pregnant
females in the intact corticosterone secretion groups were
sham-operated.
Corticosterone injection. The stressed mothers
adrenalectomized with corticosterone-substitutive treatment received a
subcutaneous injection of either saline (NaCl; 0.9% w/v) or
corticosterone (3 mg/kg) concomitantly with stress. In a separate
experiment, we showed that corticosterone injections in
adrenalectomized pregnant rats elicit plasma corticosterone levels
approximating those found in response to stress in intact mothers
(Table 1).
Corticosterone assay. Corticosterone levels were determined
in three blood samples (250 µl) withdrawn from the tail vein before
stress, after 30 min restraint stress, and 120 min afterward. Restraint
was performed in plastic cylinders identical to those used for the
prenatal stress. Blood was collected in heparinized tubes.
Corticosterone levels were determined by radioimmunoassay using a
highly specific corticosterone antiserum (ICN Biochemicals) with a
detection threshold of 0.1 µg/100 ml. The inter- and intra-assay
variations were, respectively, 6 and 3.5% at a mean value of 1.5 ng
per tube and 6.8 and 4% at a mean value of 10 ng per tube.
Type I and type II corticosteroid receptor binding. Type I
and type II hippocampal corticosteroid receptor binding was measured 2 weeks after the restraint stress procedure. Between 8:00 and 10:00
A.M., hippocampi were rapidly dissected and frozen on dry ice. Tissues
were stored at 80°C until receptor assay. To eliminate endogenous
corticosterone, an exchange assay was used for both type I and type II
corticosteroid receptors as described previously (Casolini et al.,
1993 ; Maccari et al., 1995 ). The hippocampus of each rat was
homogenized in 2 ml of ice-cold 30 mM Tris
(TEDGM; pH adjusted to 7.4 with 6N HCl) containing 1 mM EDTA, 10 mM sodium
molybdate, 1 mM dithiothreitol, and 10%
glycerol, and centrifuged (105,000 g, 15 min in a Beckman
TL100 ultracentrifuge) at 4°C. Endogenous, unbound steroids were
removed from the soluble fraction by passing the sample through LH-20
columns filled using Pasteur pipette tips and equilibrated with TEGM
buffer (10 mM Tris, 2 mM
EDTA, 10 mM sodium molybdate, and 2.3 mM -mercaptoethanol). For the type I receptor
assay, aliquots of cytosol (140 µl) were incubated with tritiated
corticosterone (specific activity 88 Ci/mmol, DuPont NEN) over a
concentration range of 1.25-40 nM (6 points for
each Scatchard plot) and with a 100-fold excess of unlabeled RU 28362. Unlabeled RU 28362 was used to displace 3H-B from
type II receptors. Type II receptor binding was evaluated directly
using the pure glucocorticoid, 3H-RU 28362 (specific activity 74.3 Ci/mmol, Dositek) over a concentration range of
1.25-40 nM (6 points for each Scatchard plot).
Nonspecific binding for 3H-B was determined in
the presence of a 500-fold excess of unlabeled corticosterone, and for
3H-RU 28362 in the presence of a 500-fold excess
of unlabeled RU 28362. Binding equilibrium was reached after 22 hr at
4°C. This has been shown to be sufficient for maximal exchange, and
binding remains stable over this period (Kalimi and Hubbard, 1983 ;
Meaney et al., 1988 ). Although exchange may not be complete, it is
comparable in all experimental groups. Bound and unbound
3H-B or 3H-RU 28362 were
separated on Sephadex LH-20 columns equilibrated with TEGDM buffer at
2°C, using 60 µl of the incubates eluted with 940 µl of TEGDM
buffer. One milliliter of the eluate containing the bound form was
added to 3.5 ml of scintillation fluid (Acqualuma, Lumac), and
radioactivity was counted. Protein concentrations were determined
according to Lowry et al. (1951) using albumin as standard. The
apparent maximum binding capacity (Bmax) of
3H-B or 3H-RU 28362 and
dissociation constants (Kd)
for both types of receptors were evaluated from Scatchard plots
(Scatchard, 1949 ) generated for each animal individually.
Procedures
Experiment 1: influence of blocking maternal
corticosterone secretion during restraint stress on corticosterone and
corticosteroid receptors of adult offspring. In this experiment,
four groups of rat offspring were compared: two groups born to either
control or stressed mothers with intact corticosterone secretion and
two groups born to either control or stressed mothers in which
stress-induced corticosterone secretion was blocked by adrenalectomy
associated with a substitutive corticosterone treatment. At 90 d of
age, offspring were submitted to a 30 min restraint stress. Restraint
was performed in plastic cylinders identical to that used for the
prenatal stress. Corticosterone levels were determined in three blood
samples (250 µl) withdrawn from the tail vein. The three samples were
collected at the beginning and end of the 30 min stress and 120 min
afterward. For the collection 120 min after the stress, the rat was
again put in the restraint cage for <2 min. Type I and type II
hippocampal corticosteroid receptor binding was measured 2 weeks
later.
Experiment 2: influence of corticosterone injections during
restraint stress to the mothers on corticosterone and corticosteroid
receptors of adult offspring. In this experiment, to study the
specific role of maternal corticosterone, four groups of rat offspring
were compared: two groups were offspring of stressed mothers whose
corticosterone secretion was either intact or blocked, and two groups
were from stressed mothers having blocked corticosterone secretion,
which received a subcutaneous injection of either saline (NaCl; 0.9%
w/v) or corticosterone (3 mg/kg) concomitantly to stress. Also in this
experiment, at 90 d of age, offspring were submitted to a 30 min
restraint stress. Basal and stress corticosterone levels were
determined as described previously. Type I and type II hippocampal
corticosteroid receptor binding was measured 2 weeks later.
Statistics. The results were compared by two-way bifactorial
analysis (ANOVA). In the first experiment, the two between factors
were: (1) stress (two levels, presence/absence); and (2) maternal
corticosterone (two levels, intact/blocked). In the second experiment,
the two between factors were: (1) corticosterone (two levels,
high/low); and (2) subcutaneous injection (two levels,
presence/absence).
RESULTS
Experiment 1. Influence of blocking maternal corticosterone
secretion during restraint stress on stress-induced corticosterone
secretion and hippocampal corticosteroid receptors of adult
offspring
At 3 months of age, offspring of stressed mothers whose
corticosterone secretion was intact showed a prolonged stress-induced
corticosterone secretion (Fig. 1) and decreased
hippocampal type I corticosterone receptors (Fig. 2).
Type I and type II hippocampal corticosteroid receptor binding had been
measured 2 weeks after the restraint stress procedure, and the
hippocampi were dissected between 8:00 and 10:00 A.M. In contrast,
offspring of stressed mothers whose corticosterone secretion was
blocked did not differ from rats of control mothers for any of the
parameters studied. A bifactorial analysis was used, and the two
between factors were: (1) stress (presence/absence); (2) maternal
corticosterone (Intact/blocked). The following main effects and
interactions were significant: (1) stress-induced corticosterone
secretion [Stress × Maternal Corticosterone × Time Interaction;
F(2,92) = 4.997; p = 0.008];
(2) corticosterone 2 hr after stress [Stress × Maternal
Corticosterone Interaction; F(1,46) = 8.34;
p = 0.006]; and (3) type I receptors [Stress × Maternal
Corticosterone Interaction; F(1,45) = 14.46; p = 0.0005].
Fig. 1.
Plasma corticosterone secretion after restraint
stress in control and prenatally stressed offspring of mothers with
intact (14-20 animals/group) or blocked (7-10 animals/group)
stress-induced corticosterone secretion. The experimental groups did
not differ in corticosterone secretion in basal conditions (left
panel) or 30 min after stress (middle panel). At 120 min after stress (right panel), prenatally stressed animals,
the mothers of which were in the intact group, had higher
corticosterone levels than controls. Prenatally stressed rats whose
mothers' corticosterone secretion was blocked did not differ from
controls. ***p < 0.001. Error bars represent SEM.
[View Larger Version of this Image (41K GIF file)]
Fig. 2.
Hippocampal corticosteroid receptors in control
and prenatally stressed offspring of mothers with intact (14-20
animals/group) or blocked (7-10 animals/group) stress-induced
corticosterone secretion. Type I corticosteroid receptors were lower in
prenatally stressed rats from mothers with intact corticosterone
secretion, whereas prenatal stress had no effect on this measure when
maternal corticosterone secretion was blocked (left panel).
No significant effects were found on the
Bmax of type II receptors (right
panel) or in the affinity of either receptor type. Mean affinities
were (in nM): type I = 1.66 ± 0.17; type II = 1.14 ± 0.21. ***p < 0.001. Error bars represent SEM.
[View Larger Version of this Image (36K GIF file)]
Experiment 2. Influence of high levels of maternal corticosterone
during restraint stress on stress-induced corticosterone secretion and
hippocampal corticosteroid receptors of adult offspring
Offspring of mothers in which corticosterone levels were high
during stress had a longer stress-induced corticosterone secretion
(Fig. 3) and lower hippocampal type I corticosteroid
receptors (Fig. 4) than animals whose mothers had low
corticosterone levels. The two between factors were: (1) corticosterone
(high/low); (2) subcutaneous Injection (presence/absence). The
following main effects and interactions were significant: (1)
stress-induced corticosterone secretion [Corticosterone × Time
Interaction; F(2,78) = 8.308; p = 0.0005]; (2) corticosterone levels 2 hr after stress
[Corticosterone Effect; F(1,39) = 11.342;
p = 0.0018]; (3) type I corticosterone receptors in the
hippocampus [Corticosterone Effect;
F(1,31) = 12.38; p = 0.0015].
Because the injection itself had no effect and no significant
interaction was found between the two main factors in Figs. 3 and 4,
results were collapsed over the injection factor.
Fig. 3.
Plasma corticosterone secretion after
restraint stress in prenatally stressed rats, the mothers of which had
either low (5-10 animals/group) or high (10-14 animals/group)
corticosterone levels when submitted to stress during pregnancy. There
were no significant differences in corticosterone secretion in basal
conditions (left panel) or 30 min after stress (middle
panel), whereas prenatally stressed rats from mothers having high
corticosterone levels had a prolonged stress-induced corticosterone
secretion (right panel). ***p < 0.001. Error
bars represent SEM.
[View Larger Version of this Image (33K GIF file)]
Fig. 4.
Hippocampal corticosteroid receptors in rats, the
mothers of which had either low (5-10 animals/group) or high (10-14
animals/group) corticosterone levels when submitted to stress during
pregnancy. Type I corticosteroid receptors were lower in animals from
mothers having high corticosterone levels (left panel). No
differences were found in the Bmax of type
II receptors (right panel) or in the affinities of either
receptor type. Mean affinities were (in nM): type
I = 1.71 ± 0.15; type II = 1.56 ± 0.30. ***p < 0.001. Error bars represent SEM.
[View Larger Version of this Image (31K GIF file)]
DISCUSSION
Taken together, these results suggest that disruption of the
hormonal response to stress observed in prenatally stressed individuals
depends on stress-induced increases in maternal glucocorticoids. The
characteristic impairment of HPA axis activity normally seen in
prenatally stressed rats was suppressed by blocking the mother's
stress-induced corticosterone secretion, using adrenalectomy associated
with a corticosterone replacement treatment. Conversely, the effects of
prenatal stress were reinstated by peripheral administration of
corticosterone (at doses mimicking stress levels) to these mothers.
The present findings are in agreement with data showing that exposure
of pregnant rats to alcohol, a procedure that stimulates maternal
glucocorticoid secretion, results in a hyperactive HPA axis in the
offspring (Rivier et al., 1984 ; Lee et al., 1990 ). However, exogenous
prenatal corticosterone replacement did not have the same effect as
prenatal ethanol exposure (Lee and Rivier, 1992 ), probably because the
corticosterone replacement was made from days 8 to 14 of gestation and
the fetal HPA axis is not functional until the middle of the third week
of gestation (Bugnon et al., 1982 ). Similarly, nonabortive maternal
infections, which increase maternal glucocorticoids (Besedovsky et al.,
1975 ; Dunn, 1992 ), compromise the development of the fetal brain and
alter HPA axis functioning in the adult (Reul et al., 1994 ). However,
maternal factors other than corticosterone can also contribute to
long-term HPA reactivity in the adult male offspring. Thus, we have
previously shown that the increased postnatal maternal care induced by
an early adoption reverses the long-term effects on HPA reactivity
induced by prenatal stress (Maccari et al., 1995 ).
Of the many actions of maternal glucocorticoids during development, at
least two may account for the observed effects on the offspring's HPA
axis. (1) High glucocorticoid levels may alter the HPA axis development
by downregulating fetal hippocampal corticosteroid receptors, which are
already fully expressed during the last week of gestation (Meaney et
al., 1985 ; Rosenfeld et al., 1988 ). (2) High glucocorticoid levels may
modify glucocorticoid secretion in the offspring by acting on the
developing noradrenergic systems. Indeed, prenatal stress is known to
increase the turnover of brain norepinephrine in adult rats (Takahashi
et al., 1992 ), and norepinephrine exerts a direct inhibitory control on
hippocampal corticosteroid receptors, thus facilitating corticosterone
secretion (Maccari et al., 1992 ; Yau and Seckl, 1992 ).
The decrease in hippocampal type I corticosteroid receptors observed in
prenatally stressed rats could account for their prolonged
stress-induced corticosterone secretion. Hippocampal corticosteroid
receptors appear to play an important role in this process, as it has
been shown that a selective reduction in hippocampal corticosteroid
receptors is accompanied by a prolonged corticosterone secretion in
response to stress (McEwen et al., 1986 ; Sapolsky et al., 1986 ). In
view of their affinities for corticosterone, it is generally thought
that type II receptors are involved in stress-induced feedback
mechanisms, whereas type I receptors are involved in the tonic
regulation of corticosterone release under basal conditions (De Kloet
and Reul, 1987 ). Thus, in the present study, the observed decrease in
hippocampal type I receptors might not be expected to be involved in
stress-modulated feedback control. However, there is now evidence that
both receptor types are involved in feedback control mechanisms. The
administration of type I antagonists induces prolonged adrenocortical
secretion after stress (Ratka et al., 1989 ), and the occupancy of both
types of receptors in the hippocampus by corticosterone is required for
the feedback suppression of corticotropin-releasing factor secretion
during stress (Sapolsky et al., 1990 ). In addition, Dallman et al.
(1989) suggested that the effect of corticosterone on basal
adrenocorticotropic hormone secretion is mediated by association with
type I receptors, and not type II. This idea is also supported by two
further observations. First, an early adoption, which suppresses the
prolonged corticosterone secretion in prenatally stressed animals, also
increases type I receptors in the hippocampus (Maccari et al., 1995 ).
Second, a selective reduction in type I hippocampal corticosteroid
receptors has been found to be associated with a prolonged
stress-induced corticosterone secretion in chronically social stressed
animals, akin to that observed in prenatally stressed rats (Maccari et
al., 1991 ).
It should be noted that the assay used to measure the above-mentioned
changes in corticosteroid receptors was an exchange assay for both type
I and type II corticosteroid receptors to eliminate endogenous
corticosterone as described previously (Kalimi and Hubbard, 1983 ;
Meaney et al., 1988 ; Casolini et al., 1993 ; Maccari et al., 1995 ). It
is important to consider that although exchange may not be complete, it
is comparable in all experimental groups given that the corticosterone
concentrations in the different groups of rats at the time of killing
were at their basal levels and, thus, essentially the same across
treatment groups. It can therefore be assumed that the decrease in type
I corticosteroid receptors was not attributable to a different
occupancy of this type of receptor by corticosterone. However, future
studies should address whether the mRNA for the type I receptor is also
lower in these animals.
There is strong evidence indicating that increased corticosterone
levels in prenatal and postnatal life have opposite effects on adult
corticosterone secretion. Thus, in contrast to the present results,
corticosterone secretion is reduced in adult rats that have received
corticosterone during the first week after birth (Turner and Taylor,
1976 ; Catalani et al., 1993 ). Although seemingly contradictory, these
profound differences in corticosterone's effects in the prenatal
versus postnatal period might be explained by a difference in the
maturational status of hippocampal corticosteroid receptors in fetus
versus pup. During the last week of fetal life, levels of
corticosteroid receptors are similar to those in adults, whereas at
birth their number is profoundly decreased, increasing again only at
12-14 d of age (Meaney et al., 1985 ; Rosenfeld et al., 1988 ).
In conclusion, the present report clearly shows the major influence of
maternal glucocorticoids on the development of endocrine function in
the offspring. Our results suggest that the high level of maternal
glucocorticoids during prenatal stress, when the fetal HPA axis is
developing, has marked long-term repercussions on the efficiency of the
offspring's HPA negative feedback mechanisms. Furthermore, given the
influence of maternal glucocorticoids on brain development, the
antenatal glucocorticoid treatment currently used for reducing the
frequency of respiratory distress syndrome and neonatal death (Farrell
and Nitzan, 1979 ; Ballard et al., 1980 ; National Institutes of Health
Consensus Statement, 1994 ) may not be without negative long-term side
effects.
FOOTNOTES
Received Jan. 11, 1996; revised April 2, 1996; accepted April 3, 1996.
This work was supported by Institut National de la Santé et de la
Recherche Médicale, Université de Bordeaux II and Conseil
Regional d'Aquitaine. We thank Dr. J. Day for helpful comments and
Roussel-UCLAF for providing RU 28362.
Correspondence should be addressed to Stefania Maccari, Institut
National de la Santé et de la Recherche Médicale U259,
Université de Bordeaux II, Domaine de Carreire, Rue Camille Saint
Saëns, 33077 Bordeaux Cedex, France.
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