Collaborative trial of prenatal thyrotropin-releasing hormone and corticosteroids for prevention of respiratory distress syndrome

Torres P.J.; Salinas, R; Maturana A.; Rubio, R; Gonzalez L.H.; Cox H.; Biotti M.; D'Apremont, I; Gonzales F.; Rubio, L.; Rios A.; Balboa P.; Sfeir J.; Román Á.; Echeverria, P; et. al.

Keywords: alcohols, age, oxygen, hormone, prematurity, intravenous, mortality, care, risk, pregnancy, maturation, trial, double-blind, treatment, multicenter, gestational, humans, lung, human, polyethylene, fetus, newborn, surfactant, thyroid, hormones, outcome, prolactin, adult, female, surfactants, cortex, drug, article, incidence, betamethasone, dose-response, maternal, analysis, blind, respiratory, combinations, welfare, pulmonary, assessment, method, controlled, intramuscular, statistical, clinical, distress, study, adrenal, priority, phosphorylcholine, administration, journal, syndrome, fatty, double, Relationship,, major, Syndrome,, Infant,, Injections,, procedure, randomized, Glycols, corticosteroid, indication, protirelin, Thyrotropin-Releasing

Abstract

OBJECTIVE: Our purpose was to determine whether adding antenatal thyrotropin-releasing hormone to prenatal corticosteroids reduces the frequency of respiratory distress syndrome. STUDY DESIGN: A randomized, multicenter, double-blind, placebo-controlled trial was conducted of thyrotropin-releasing hormone (400 ?g intravenously every 8 hours four times) in women with singleton pregnancies <33 weeks of gestation who received antenatal betamethasone (12 mg intramuscularly every 24 hours two times). Neonates weighing <1.0 kg received prophylactic surfactant and those above that weight received rescue therapy. RESULTS: One hundred ninety women received thyrotropin-releasing hormone and 180 were given placebo. There were no differences in the frequency of respiratory distress syndrome (relative risk 1.17 [95% confidence interval 0.93 to 1.48]), use of oxygen at age 28 days (1.14 [0.80 to 1.62]), or neonatal mortality (1.05 [0.79 to 1.38]). Air leaks were more frequent in the thyrotropin-releasing hormone group (1.57 [1.23 to 2.01]). CONCLUSIONS: The combination of antenatal thyrotropin- releasing hormone and corticosteroids does not reduce the frequency of respiratory distress syndrome or improve the outcome of preterm neonates compared with the use of corticosteroids alone.

Más información

Título de la Revista: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
Volumen: 178
Número: 1 I
Editorial: MOSBY-ELSEVIER
Fecha de publicación: 1998
Página de inicio: 33
Página final: 39
URL: http://www.scopus.com/inward/record.url?eid=2-s2.0-7144253142&partnerID=q2rCbXpz
DOI:

10.1016/S0002-9378(98)70622-2