Prolactin and Growth Hormone in Perinatal Asphyxia

Varvarigou, Anastasia; Vagenakis, Apostolos G.; Makri, Maria; Frimas, C.; Beratis, Nicholas G.

doi:10.1159/000244281

Cited by 10 publications

(4 citation statements)

References 9 publications

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“…1,500 g has not been investigated. Our study shows that values of TSH, T4, and PRL in newborns treated with dopamine infusion are signifi cantly lower than those obtained in newborns of control group and than the normal values reported in literature [19][20][21] . Because, the present study was non-randomized, we cannot exclude the possibility that any effects, which are now attributed to dopamine, may also be, at least partly, due to the clinical conditions that prompted the use of dopamine.…”

Section: Discussioncontrasting

confidence: 74%

Dopamine Infusion and Anterior Pituitary Gland Function in Very Low Birth Weight Infants

et al. 2006

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Background: Previous studies demonstrated that dopamine infusion reduces plasma concentration of thyroxine (T4), thyroid stimulating hormone (TSH), prolactin (PRL), and growth hormone (GH) in adults, children, and infants. Objectives: The purpose of this prospective observational study was to evaluate the relationship between dopamine infusion and the dynamics of T4, TSH, PRL, and GH in preterm newborns weighing less than 1,500 g (very low birth weight infants, VLBW) admitted in a neonatal intensive care unit of a university hospital over a one year period. Methods: A total of 97 preterm newborns were enrolled and divided into two groups: group B included hypotensive infants treated with plasma expanders and dopamine infusion; group A was the control group including newborns who were never treated with dopamine. The newborns were studied dynamically through blood samples taken every day till 10 days. Newborns of group B were studied during dopamine infusion and after its withdrawal. Results: Among the VLBW newborns who were given dopamine, the four pituitary hormones had different dynamics: a reduction of T4, TSH, and PRL levels was noticed since the first day of treatment, and a rebound of their levels was evident since the first day after its interruption. On the contrary, the postprandial GH levels were roughly constant: GH plasma concentrations were in fact a little lower in newborns treated with dopamine, and a slight increase was observed after its withdrawal. However, observed differences were not statistically significant. Conclusions: The results suggest that dopamine infusion reduces T4, TSH, and PRL plasma levels in preterm VLBW infants and have no effect on postprandial GH rate. This hormonal suppression reverses rapidly after dopamine withdrawal. This observation suggests that the iatrogenic pituitary suppression probably cannot produce long-term injuries.

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Section: Discussioncontrasting

confidence: 74%

Dopamine Infusion and Anterior Pituitary Gland Function in Very Low Birth Weight Infants

et al. 2006

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“…Varvarigou et al [27] measured the GH levels of healthy and asphyxiated babies and found higher GH levels in the asphyxiated infants. But the lowest concentrations were in the group with severe HIE.…”

Section: Discussionmentioning

confidence: 99%

Serum Insulin-Like Growth Factor 1 and Growth Hormone Levels of Hypoxic-Ischemic Newborns

et al. 2004

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A number of growth factors, their binding proteins, and their receptors have been shown to be induced in the hypoxic-ischemic (HI) brain. In this prospective study, we aimed at determining the levels of insulin-like growth factor 1 (IGF-1), growth hormone (GH), and cortisol in HI babies and at identifying whether they differ from the levels of control infants. The serum IGF-1 levels were measured after the first 12–24 h of life, and the measurements were repeated on the 5th and 10th days of life for babies with HI encephalopathy (n = 18) and on the 10th day of life for controls (n = 19). Blood samples for measurement of cortisol and GH from both HI and control groups were collected after the first 12–24 h of life. There were 11 babies in the mild-to-moderate (stages I and II) group and 7 babies in the severe (stage III) group according to Sarnat and Sarnat. The IGF-1 levels of the HI group measured after 12–24 h [78.5 ± 27.9 (range 9–123.4) ng/ml] and on the 10th day [72.2 ± 36.8 (range 29.7–159.2) ng/ml] of life were statistically significantly lower than the IGF-1 levels of the control group [121.5 ± 50.4 (range 74.4–280.5) ng/ml and 133.1 ± 34.4 (range 65.9–202) ng/ml, respectively] (p = 0.002 and p = 0.001, respectively). But there was no statistically significant difference between mild-to-moderate HI group and severe HI group in terms of IGF-1 levels after 12–24 h and 5 and 10 days of life (p > 0.05). Also there was no statistically significant difference in IGF-1 values after the first 12–24 h and after 10 days of life between HI subjects who died or survived (p > 0.05). The GH levels of the HI group after the first 12–24 h of life [34.6 ± 32.3 (range 0.1–120) mIU/l] were statistically significantly higher than those in the control group [10.4 ± 4.5 (range 3.7–16.9) mIU/l] (p = 0.005). There was no statistically significant difference in the serum cortisol levels between HI and control groups after the first 12–24 h of life [18.7 ± 17.0 (range 1.6–65.1) µg/dl vs. 10.8 ± 5.4 (range 3.0–23.2) µg/dl] (p > 0.05). No statistically significant correlation was found between IGF-1 levels and GH and cortisol levels of the HI encephalopathy group [r = –0.113 (p > 0.05) and r = 0.108 (p > 0.05), respectively]. In conclusion, this study showed decreased levels of serum IGF-1 and increased levels of GH which may be secondary to serum IGF-1 influx from the circulation to the brain as a protective mechanism or may be due to some cytokines which alter the GH/IGF axis, inhibit the action of IGF-1, and stimulate IGF-binding protein 1.

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“…In fact, PRL levels appear higher in infants born from vaginal delivery after labor and also from emergency cesarean section performed during labor than in infants delivered by elective cesarean section, indicating stimulation of fetal hypothalamic-pituitary axis during labor [222]. Significantly elevated PRL levels were also observed in neonates who experienced hypoxic-ischemic encephalopathy with seizures [223,225,226]. Moreover, basing on biochemical studies in animal models, PRL was recently hypothesized to play a considerable role in late fetal maturation and neonatal adaptation to extrauterine life, with particular concern in energetic-metabolic balance [227][228][229].…”

Section: A Physiology Of Prl In Neonates and Vlbw Infantsmentioning

confidence: 95%

“…PRL can be considered a mediator of the stress response [222][223][224] as it was observed to rise in neonates undergoing different stressful insults. In fact, PRL levels appear higher in infants born from vaginal delivery after labor and also from emergency cesarean section performed during labor than in infants delivered by elective cesarean section, indicating stimulation of fetal hypothalamic-pituitary axis during labor [222].…”

Section: A Physiology Of Prl In Neonates and Vlbw Infantsmentioning

confidence: 99%

Dopamine Administration in Very Low Birth Weight Preterm Infants:Emerging Issues on Endocrine Effects

Filippi¹,

Poggi²,

Pezzati

2007

CPR

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Preterm newborns weighing less than 1500 g (very low birth weight infants, VLBW) represent a critical population with high prevalence of morbidities, often requiring hemodynamic stabilization. Dopamine is a natural cathecolamine widely used for this purpose because it exerts pleiotropic anti-shock effects on cardiovascular, renal and endocrine systems, acting on adrenergic and dopaminergic receptors. Dopamine is a first choice drug in VLBW infants for inotropic support and optimisation of renal and splanchnic perfusion, mostly indicated for the treatment of hypotension, symptomatic patent ductus arteriosus and renal failure.Dopamine reversibly suppresses pituitary functions in adults but its effects on endocrine balance have been poorly studied in VLBW infants. Recent studies showed a dose-dependant reduction of TSH and T4 plasmatic levels in dopamine-treated VLBW infants and a positive correlation between dopamine infusion and incidence of transient hypothyroxinemia of prematurity.Further studies demonstrated that dopamine infusion also reduces PRL secretion in VLBW infants. TSH, T4 and PRL suppression rapidly reverses after dopamine withdrawal, when a significant hormonal rebound is observed. Therefore, such iatrogenic suppression probably cannot involve long-term injuries and T4 substitutive administration appears unecessary during short course dopamine treatment.Recent observations suggest that dopamine infusion can prevent early diagnosis of congenital hypothyroidism (CH) when screening programs are merely based on TSH plasmatic levels. Considering the severe neurodevelopmental outcome of undiagnosed CH, other screening strategies should be considered in treated neonates, such as simultaneous T4 and TSH testing and hormonal re-evaluation after dopamine discontinuation.A final issue of this review regards a possibile role of dobutamine as an alternative safer inotropic drug. PART 1. DOPAMINE AND DOBUTAMINE ADMINI-STRATION IN PRETERM INFANTS Clinical BackgroundPreterm infants weighing at birth less than 1500 g are referred to as very low birth weight (VLBW) infants and presently account for about 1-3 % of all neonates [1, 2]. However, they represent a widening subset of neonates with major vulnerability among the whole neonatal population. In fact, VLBW infants show a high incidence of morbitidies and systemic hypotension affects approximately one third of these infants [3]. Therefore, they often require early and careful hemodinamic stabilisation and, as a matter of fact, from 4% to 39% of VLBW infants receive inotropic support [3].Even if at present there are no clear evidences that the treatment of systemic hypotension is beneficial [4,5], such condition is widely and aggressively treated in VLBW infants in order to preserve a proper organ perfusion and an adequate cerebral blood flow [3,4,[6][7][8][9][10][11][12] since hypotension results associated with increased risk of intraventricular haemorrhage and unfavourable neurodevelopmental outcome [13][14][15][16]. Impaired cerebral autoregulation has been dem...

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Prolactin and Growth Hormone in Perinatal Asphyxia

Cited by 10 publications

References 9 publications

Dopamine Infusion and Anterior Pituitary Gland Function in Very Low Birth Weight Infants

Dopamine Infusion and Anterior Pituitary Gland Function in Very Low Birth Weight Infants

Serum Insulin-Like Growth Factor 1 and Growth Hormone Levels of Hypoxic-Ischemic Newborns

Dopamine Administration in Very Low Birth Weight Preterm Infants:Emerging Issues on Endocrine Effects

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