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Preterm Bebeklerde Antenatal Betametazon Tedavisinin Serum Tiroid Hormon Düzeylerine Etkisi

Year 2020, Volume: 14 Issue: 6, 488 - 492, 30.11.2020
https://doi.org/10.12956/tchd.701610

Abstract

Amaç: Yenidoğan ölümleri ve ağır morbiditelerini azaltan antenatal betametazon tedavisinin preterm bebeklerdeki serum tiroid hormonlarına etkisinin araştırılması amaçlanmıştır.
Gereç ve

Yöntemler: 2013-2019 yılları arasında doğan ve gebelik haftası 32 hafta ve altında olan ve çalışmaya alınma kriterlerini karşılayan toplam 156 bebek bu retrospektif çalışmaya alındı. Bebeklerin bilgilerine hastane kayıt sisteminden ulaşıldı. Bebekler hiç steroid almayan, tek doz alan ve tam doz alan olmak üzere üç gruba ayrıldı. Yaşamın 30. gününden önce bakılan tiroid fonksiyon testleri karşılaştırıldı.

Bulgular: Doğum haftası, doğum şekli, doğum ağırlığı, çoğul gebelik durumu, cinsiyet, anne yaşı, preeklampsi, erken membran rüptürü, koriyoamniyonit, annede tiroid hastalığı, bebeğin hastanede kalma süresi, tiroid testi örneklem zamanı, Apgar skoru, patent duktus arteriyozus, nekrotizan enterokolit, intraventriküler kanama, prematüre retinopatisi ve bronkopulmoner displazi oranı açısından her üç grup arasında fark saptanmadı. Tam doz steroid alanlarda surfaktan ihtiyacı anlamlı olarak düşüktü. Serum serbest tiroksin (sT4) ve tiroid uyarıcı hormon (TSH) düzeyleri açısından her üç grup arasında fark saptanmadı.

Sonuç: Bu çalışmada preterm bebeklerde antenatal betametazon profilaksisinin serum tiroid hormonlarına etkisinin olmadığı görülmüştür.

References

  • 1. Briceño-Pérez C, Reyna-Villasmil E, Vigil-De-Gracia P. Antenatal corticosteroid therapy: Historical and scientific basis to improve preterm birth management. Eur J Obstet Gynecol Reprod Biol. 2019 Mar;234:32-37
  • 2. Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA. 2015;314:1039–51.
  • 3. Ansari MA, de Mello DE, Devaskar UP. Effect of prenatal glucocorticoid on fetal lung ultrastructural maturation in hyt/hyt mice with primary hypothyroidism. Biol Neonate. 2000;77(1):29-36.
  • 4. Chung HR. Screening and management of thyroid dysfunction in preterm infants. Ann Pediatr Endocrinol Metab. 2019 Mar;24(1):15-21.
  • 5. Liggins GC. Adrenocortical-related maturational events in the fetus. Am J Obstet Gynecol. 1976 Dec 1;126(7):931-41.
  • 6. Hillman NH, Kallapur SG, Jobe AH. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol. 2012;39(4):769–83.
  • 7. Polk DH, Ikegami M, Jobe AH, Newnham J, Sly P, Kohen R, et al. Postnatal lung function in preterm lambs: effects of a single exposure to betamethasone and thyroid hormones. Am J Obstet Gynecol. 1995;172:872–81.
  • 8. Ikegami M, Polk D, Tabor B, Lewis J, Yamada T, Jobe A. Corticosteroid and thyrotropin-releasing hormone effects on preterm sheep lung function. J Appl Physiol (1985). 1991 May ;70(5):2268–78.
  • 9. Osathanondh R, Chopra IJ, Tulchinsky D. Effects of dexamethasone on fetal and maternal thyroxine, triiodothyronine, reverse triiodothyronine and thyrotropin levels. J Clin Endocrinol Metab. 1978 Dec;47(6):1236–9.
  • 10. Ballard PL, Ballard RA, Creasy RK, Padbury J, Polk DH, Bracken M, et al. Plasma thyroid hormones and prolactin in prematüre infants and their mothers after prenatal treatment with thyrotropin-releasing hormone. Pediatr Res. 1992 Dec; 32(6): 673–8.
  • 11. Franklin RC, Purdie GL, O’Grady CM. Neonatal thyroid function: prematurity, prenatal steroids, and respiratory distress syndrome. Arch Dis Child. 1986 Jun;61(6):589–92.
  • 12. Kaluarachchi DC, Zhao Q, Colaizy TT. Antenatal steroids and thyroid hormone function in preterm infants. J Perinatol. 2018 Nov;38(11):1466-70.
  • 13. Simpson J, Williams FL, Delahunty C, van Toor H, Wu SY, Ogston SA, et al. Scottish Preterm Thyroid Group. Serum thyroid hormones in preterm infants and relationships to indices of severity of intercurrent illness. J Clin Endocrinol Metab. 2005 Mar;90(3):1271-9.
  • 14. Martin CR, Van Marter LJ, Allred EN, Leviton A; Developmental Epidemiology Network. Antenatal glucocorticoids increase early total thyroxine levels in premature infants. Biol Neonate. 2005;87(4):273-80.
  • 15. Léger J, Olivieri A, Donaldson M, Torresani T, Krude H, van Vliet G, et al.Polak; ESPE-PES-SLEP-JSPE-APEG-APPES-ISPAE; Congenital Hypothyroidism Consensus Conference Group. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab. 2014 Feb;99(2):363-84.

The Effect of Antenatal Betamethasone Treatment On Serum Thyroid Hormone Levels of Preterm Infants

Year 2020, Volume: 14 Issue: 6, 488 - 492, 30.11.2020
https://doi.org/10.12956/tchd.701610

Abstract

Objective: In this study, we aimed to investigate the effect of antenatal betamethasone treatment on serum thyroid hormones in preterm infants.

Material and Methods: A total of 156 babies born between 2013-2019 with gestational age of ≤32 weeks were included in this retrospective study. Information of the babies was accessed from the hospital records. Infants were divided into 3 groups according to betamethasone treatment: no treatment, partial dose, and complete dose. Thyroid function tests were compared between the groups before 30th days of life.

Results: There was no difference between the three groups in terms of gestational age, route of delivery, birth weight, rate of multiple pregnancy, gender, maternal age, premature rupture of membranes, chorioamnionitis, maternal thyroid disease, hospital stay, sampling time of serum thyroid hormones, Apgar score, patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity and bronchopulmonary dysplasia. The surfactant treatment was significantly low in the patients receiving complete dose of steroid. There was no difference between the three groups in terms of serum free thyroxine (fT4) and thyroid stimulating hormone (TSH) levels.

Conclusion: It has been shown that antenatal betamethasone treatment has no effect on serum thyroid hormones in preterm infants.

References

  • 1. Briceño-Pérez C, Reyna-Villasmil E, Vigil-De-Gracia P. Antenatal corticosteroid therapy: Historical and scientific basis to improve preterm birth management. Eur J Obstet Gynecol Reprod Biol. 2019 Mar;234:32-37
  • 2. Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA. 2015;314:1039–51.
  • 3. Ansari MA, de Mello DE, Devaskar UP. Effect of prenatal glucocorticoid on fetal lung ultrastructural maturation in hyt/hyt mice with primary hypothyroidism. Biol Neonate. 2000;77(1):29-36.
  • 4. Chung HR. Screening and management of thyroid dysfunction in preterm infants. Ann Pediatr Endocrinol Metab. 2019 Mar;24(1):15-21.
  • 5. Liggins GC. Adrenocortical-related maturational events in the fetus. Am J Obstet Gynecol. 1976 Dec 1;126(7):931-41.
  • 6. Hillman NH, Kallapur SG, Jobe AH. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol. 2012;39(4):769–83.
  • 7. Polk DH, Ikegami M, Jobe AH, Newnham J, Sly P, Kohen R, et al. Postnatal lung function in preterm lambs: effects of a single exposure to betamethasone and thyroid hormones. Am J Obstet Gynecol. 1995;172:872–81.
  • 8. Ikegami M, Polk D, Tabor B, Lewis J, Yamada T, Jobe A. Corticosteroid and thyrotropin-releasing hormone effects on preterm sheep lung function. J Appl Physiol (1985). 1991 May ;70(5):2268–78.
  • 9. Osathanondh R, Chopra IJ, Tulchinsky D. Effects of dexamethasone on fetal and maternal thyroxine, triiodothyronine, reverse triiodothyronine and thyrotropin levels. J Clin Endocrinol Metab. 1978 Dec;47(6):1236–9.
  • 10. Ballard PL, Ballard RA, Creasy RK, Padbury J, Polk DH, Bracken M, et al. Plasma thyroid hormones and prolactin in prematüre infants and their mothers after prenatal treatment with thyrotropin-releasing hormone. Pediatr Res. 1992 Dec; 32(6): 673–8.
  • 11. Franklin RC, Purdie GL, O’Grady CM. Neonatal thyroid function: prematurity, prenatal steroids, and respiratory distress syndrome. Arch Dis Child. 1986 Jun;61(6):589–92.
  • 12. Kaluarachchi DC, Zhao Q, Colaizy TT. Antenatal steroids and thyroid hormone function in preterm infants. J Perinatol. 2018 Nov;38(11):1466-70.
  • 13. Simpson J, Williams FL, Delahunty C, van Toor H, Wu SY, Ogston SA, et al. Scottish Preterm Thyroid Group. Serum thyroid hormones in preterm infants and relationships to indices of severity of intercurrent illness. J Clin Endocrinol Metab. 2005 Mar;90(3):1271-9.
  • 14. Martin CR, Van Marter LJ, Allred EN, Leviton A; Developmental Epidemiology Network. Antenatal glucocorticoids increase early total thyroxine levels in premature infants. Biol Neonate. 2005;87(4):273-80.
  • 15. Léger J, Olivieri A, Donaldson M, Torresani T, Krude H, van Vliet G, et al.Polak; ESPE-PES-SLEP-JSPE-APEG-APPES-ISPAE; Congenital Hypothyroidism Consensus Conference Group. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab. 2014 Feb;99(2):363-84.
There are 15 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section ORIGINAL ARTICLES
Authors

Ayşe Anık 0000-0002-0673-3403

Berfu Vurmaz This is me 0000-0003-3880-0401

Sercan Öztürk This is me 0000-0002-7952-5656

Tolga Ünüvar 0000-0002-5517-5030

Abdullah Barış Akcan 0000-0003-0181-1166

Ahmet Anık 0000-0002-7729-7872

Münevver Türkmen 0000-0001-8436-6613

Publication Date November 30, 2020
Submission Date March 13, 2020
Published in Issue Year 2020 Volume: 14 Issue: 6

Cite

Vancouver Anık A, Vurmaz B, Öztürk S, Ünüvar T, Akcan AB, Anık A, Türkmen M. Preterm Bebeklerde Antenatal Betametazon Tedavisinin Serum Tiroid Hormon Düzeylerine Etkisi. Türkiye Çocuk Hast Derg. 2020;14(6):488-92.


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