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Abstract

Research in Pediatrics & Neonatology

The Relationship of Blood Prolactin, Cortisol and Thyroid Hormones in Prematural Newborns with Respiratory Distress Syndrome

Submission: September 06, 2019; Published: September 24, 2019

ISSN : 2576-9200
Volume3 Issue5

Abstract

RDS is one of the leading causes of morbidity and mortality in preterm infants. It is well known that the main reason for RDS development is the deficiency of pulmonary surfactant. Various endogenous hormones such as prolactin, cortisol, testosterone, estradiol, estrone, thyroxine, and triiodothyronine play a major role in fetal lung maturation. Neonates with low birth weights and low gestational age are reported to have a higher risk of developing RDS than average. Several studies which investigated the relationship between thyroid hormones and RDS had shown that infants with RDS have lower free T4 (fT4) and total (tT4) serum levels than infants without RDS although both groups had similar gestational ages and birth weights. Serum prolactin level of neonates increases proportionally with their gestational ages and their birth weights.

Numerous studies have been shown infants who have lower serum prolactin levels have an increased risk of developing RDS, therefore prolactin might be an important factor in fetal lung maturation. A rise cortisol concentration in cord blood is recorded before the rise in lecithin/sphingomyelin ratio (an indicator of surfactant maturation), an inverse relationship between the cortisol concentration and RDS occurrence is found, and cortisol administration before conception in risky pregnancies seemed to speed up surfactant maturation. These findings favor the cortisol as one of the key factors in fetal surfactant maturation, therefore, making the cortisol administration a vital aspect of RDS prevention. 56 neonates without RDS and 61 neonates with RDS, in total 117 neonates younger than 37 weeks of gestational age were examined (prospectively or retrospectively). Blood samples from each of them were taken in their first 24 hours of life and TSH, fT4, tT4, cortisol, and prolactin quantities were measured. Some statistical differences were found when they grouped according to their RDS development and birth weights. RDS found to increase mortality in infants. 5th minute APGAR scores of RDS and non-RDS neonates compared and no statistically significant differences found. Although most infants with RDS had 5th minute APGAR scores between 4 to 7 and most of the neonates without RDS had scores of above 7. Hospital stay for infants with RDS was significantly longer. TSH, fT4, cortisol, Tt4, and prolactin levels were compared according to the presence of RDS and tT4, cortisol, and prolactin values were significantly lower in infants with RDS. Also, TSH and prolactin levels of neonates with RDS seemed to decrease as the babies gestational age lowered. Neonates without RDS and have a gestational age of 28-30 weeks are found to have the highest cortisol level amongst other groups.

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