EFFECTS OF PRENATAL EXPOSURE TO BETAMETHASONE AND INDOMETHACIN ON THEGLOMERULAR-FILTRATION RATE IN THE PRETERM INFANT

The effects of gestational age (GA), body weight, and prenatal exposur e to betamethasone and indomethacin on the glomerular filtration rate (GFR) on d 3 of life in preterm infants were studied. GFR measurements were performed in 147 preterm infants with a GA between 23.4 and 37.0 wk by means of the continuous inulin infusion technique. Mean GFR val ues increased significantly with GA (r = 0.60, p < 0.001) and with bod y weight (r = 0.44, p < 0.001). Multivariate analysis indicated that G A was the most important determinant for this increase. Prenatal expos ure to indomethacin resulted in significantly lower GFR values (-0.15 +/- 0.03 mL/min, p < 0.001) at d 3 after birth. Prenatal administratio n of betamethasone and indomethacin significantly (p < 0.001) increase d the GFR in comparison with exposure to indomethacin alone to levels not different than those seen in patients who were not prenatally expo sed to betamethasone or indomethacin. GFR measurements were repeated i n 40 preterm infants an d 10 after birth. During this 7-d period, a si gnificant increase in GFR values (0.17 +/- 0.03 mL/min, p < 0.001) was detected. This postnatal increase in GFR values was independent of GA and was not influenced by prenatal exposure to betamethasone or indom ethacin. We conclude that prenatal exposure to betamethasone or indome thacin exerts significant effects an the renal function of preterm inf ants in the first days of life.