The impact of corticosteroids on the developing animal

Infants are subjected to both endogenous and exogenous corticosteroids in t he pre- and postnatal periods. Stress to the mother before birth, or to the child postpartum, can give rise to high, chronic endogenous corticosteroid levels caused by activation of the hypothalamic-pituitary-adrenal (HPA) ax is. Physician-administered exogenous corticosteroids are also used in the m anagement of a wide spectrum of pre- and postnatal conditions. The long-ter m effects of corticosteroids in developing humans are not well known. Studi es in animals, however, indicate that both natural stress and exogenous cor ticosteroids can have longlasting and deleterious effects on the body, brai n, behavior, and hypothalamic-pituitary-adrenal axis of developing infants. These data suggest that exogenous corticosteroids should be administered w ith caution, after careful benefit/risk analyses, and that, as far as possi ble, the developing brain should be protected against the effects of pre- a nd postnatal stress.