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Antenatal Thyrotropin-Releasing Hormone to Prevent Respiratory Distress Syndrome in Preterm

Journal of the Korean Pediatric Society 1999;42(7):911-920.
Published online July 15, 1999.
Antenatal Thyrotropin-Releasing Hormone to Prevent Respiratory Distress Syndrome in Preterm
Ai-Rhan Kim1, Sung-Jong Park1, Hye-Sun Yoon1, Ki-Soo Kim1, Hye-Sung Won2, In-Sik Lee2, Ahm Kim2, Soo-Young Pi1
1Deparment of Pediatrics, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
2Deparment of Obsterics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
미숙아 호흡 곤란 증후군 예방을 위한 산전 Thyrotropin-Releasing Hormone과 Dexamethasone 치료에 대한 비교연구
김애란1, 박성종1, 윤혜선1, 김기수1, 원혜성2, 이인식2, 김암2, 피수영1
1울산대학교 의과대학 서울중앙병원 소아과
2울산대학교 의과대학 서울중앙병원 산부인과
Correspondence: 
Ai-Rhan Kim, Email: 1
Abstract
Purpose
: The purpose of this study was to assess the efficacy of antenatal thyrotropin-releasing hormone(TRH) given to mothers at risk for preterm delivery and assess various neonatal outcomes in infants born to these mothers.
Methods
: Sixty-one mothers(TRH+Dexamethasone(D):30, D:31) with preterm labor at 26-34 weeks of gestational age were randomized into a study group which received 400μg of TRH at 8 hour interval intravenously(maximum doses of 6) along with 6 mg of D at 12 hour interval intravenously(maximum doses of 4) and into a control group that received the same regimen of D only. Among 61 mothers, 17 mothers(TRH+D:8, D:9) underwent amniocentesis to document changes in L/S ratio and lamellar body count before and after TRH and or D therapy. Thyroid function tests(TFT's) were obtained from infants born at/shortly after birth, near first week and second week of life.
Results
: Incidences of respiratory distress syndrome(42% vs 30%) and chronic lung disease(56% vs 44%) were not statistically different between the two groups. In fact, greater risk for ventilation at 28 days was observed in infants born within 24 hours of TRH treatment. All other neonatal outcomes except pulmonary hemorrhage(0% vs. 16%) were similar between TRH+D and D groups. TFT of infants born to mothers who received the last mean duration of TRH at 178 hours were similar between the two groups.
Conclusion
: Antenatal administration of TRH in addition to D did not have any additional beneficial effects compared to giving D alone.
Key Words: Antenatal TRH, Preterm, Respiratory distress syndrome


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