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Study to Examine the Effects of Synthetic Steroids on Blood Pressure and Kidney Function

WINSTON-SALEM, N.C. – Wake Forest University Baptist Medical Center researchers have received a grant of about $5 million from the National Institutes of Health to study factors that may increase premature infants’ risk for high blood pressure and kidney disease later in life.

“The project is aimed at understanding the potential causes of these problems so that early monitoring and intervention strategies can be developed,” said James C. Rose, Ph.D., the principal investigator. “The long-term benefit could be to reduce the health problems associated with high blood pressure and reduced kidney function.”

Premature infants frequently suffer health problems because their lungs are not fully developed. Currently the best treatments are to give the mother synthetic steroids and to prolong the pregnancy for as long as possible. “The kidneys are also in a critical stage of development in the second and third trimesters of pregnancy,” Rose said.

Rose, director of the Obstetric and Gynecologic Research Center, said, “This grant is designed to investigate the hypothesis that prenatal events can lead to alterations in kidney function and blood pressure control when these children reach their adolescent years.”

Sheep will be studied to learn how synthetic steroids given during pregnancy may act in the brain to alter regulation of blood pressure, affect the development of the kidneys and affect the ability of the kidneys to control the regulation of salt and water.

These findings will be compared to blood pressure regulation and kidney function in 14- year-olds who were exposed to synthetic steroids before birth. About 200 adolescents who were born prematurely and were cared for in the Neonatal Intensive Care Units at either Brenner Children’s Hospital or Forsyth Medical Center will be part of the study.

Lisa K. Washburn, M.D., an assistant professor of pediatrics at Brenner Children’s Hospital, said, “To learn more about the regulation of blood pressure and kidney function in these adolescents, we will study their body composition, diet and level of fitness as well as how they respond to exercise and cold.”

Other studies suggest that children treated with synthetic steroids prior to premature delivery may be at higher risk for developing high blood pressure, diabetes, and excessive weight gain as they grow older. “We think a study of this type will identify some of the causes underlying these problems and point to prevention strategies such as changes in lifestyle, diet and physical activity to more effectively treat these problems,” Washburn said.

The grant, which came through the NIH’s Institute of Child Health and Human Development, will go to a team of investigators from the departments of Obstetrics and Gynecology, Internal Medicine, Pediatrics, Physiology and Pharmacology, Public Health Sciences, and Radiology, as well as the Hypertension and Vascular Disease Center, and Wake Forest University’s Health and Exercise Science Department.

Rose said. “This seemed like a natural collaboration of the basic and clinical sciences since the project leaders have expertise in physiology, biochemistry, exercise science and care of neonatal infants.”

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Media Contacts: Ann Hopkins, prmtemp@wfubmc.edu, or Karen Richardson, krchrdsn@wfubmc.edu, at (336) 716-4587.

About Wake Forest University Baptist Medical Center: Wake Forest Baptist is an academic health system comprised of North Carolina Baptist Hospital, Wake Forest University Health Sciences and Brenner Children’s Hospital. The system comprises 1,187 acute care, rehabilitation, psychiatry and long-term care beds and is consistently ranked as one of “America’s Best Hospitals” by U.S. News & World Report. Brenner Children’s was named one of the top 30 best children’s hospitals in the nation by Child magazine.

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