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Published on: August 25, 2014
Neurodevelopmental outcome of children treated with antenatal thyrotropin-releasing hormone
Judy M Briët1, Loekie van Sonderen, Maarten Buimer
1Department of Neonatology, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. j.m.briet@amc.uva.nl
Insights
Antenatal thyrotropin-releasing hormone (TRH) treatment in preterm infants did not improve neurodevelopmental outcomes. Infants exposed to TRH showed lower mental development scores at 12 and 24 months, indicating a potential developmental delay.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Perinatal Research
Background:
- The European Antenatal TRH trial aimed to improve respiratory outcomes and reduce mortality in preterm infants.
- Investigating the long-term neurodevelopmental effects of antenatal thyrotropin-releasing hormone (TRH) is crucial for understanding its safety and efficacy.
Purpose of the Study:
- To evaluate the neurodevelopmental outcome up to 2 years of age in infants exposed to antenatal TRH.
- To assess the impact of TRH on cognitive and psychomotor development in preterm infants.
Main Methods:
- A multicenter trial involving infants born before 30 weeks' gestation.
- Mothers received corticosteroids plus either placebo or TRH (400 mcg every 8 hours for 4 doses).
- Neurodevelopmental assessments included neurologic and psychomotor development using Bayley scales at 12 and 24 months.
Main Results:
- Sixty-two infants were included; 10 died, and 10 were lost to follow-up.
- The TRH group experienced more respiratory problems and chronic lung disease.
- No significant differences in neurologic or motor outcomes were observed, but the TRH group had lower mental developmental index scores.
Conclusions:
- Antenatal TRH treatment is associated with a delay in mental development in preterm infants.
- This study highlights the necessity of long-term follow-up in perinatal intervention trials to identify potential neurodevelopmental consequences.
Objective:
To evaluate neurodevelopmental outcome until 2 years of age in children who participated in a multicenter antenatal thyrotropin-releasing hormone (TRH) trial to improve respiratory outcome and to lower mortality.
Methods:
Neurodevelopmental outcome was studied in infants whose mothers were admitted to the Academic Medical Center and enrolled in the European Antenatal TRH trial. Mothers were treated for imminent preterm delivery (before 30 weeks) with corticosteroids plus either placebo (placebo-group) or TRH (TRH-group). TRH treatment consisted of 400 micro g every 8 hours up to 4 doses. Assessments included neurologic development at 12 months and psychomotor development at 12 and 24 months using the Bayley developmental scales.
Results:
Sixty-two infants were included, 10 of whom died. Of the surviving infants, 24 received TRH and 28 received placebo. Ten infants were lost to follow-up. Each group consisted of 21 infants. Both groups were comparable regarding gestational age, birth weight, and time interval between trial medication and birth. However, in the TRH group, more respiratory problems, ventilator days, and chronic lung disease were found. Neurologic and motor outcome did not differ between the groups, but lower mental developmental index scores were found in the TRH group at both ages.
Conclusions:
Antenatal TRH treatment is associated with a delay in mental development. This study demonstrates the importance of long-term follow-up of perinatal intervention trials with possible consequences for neurodevelopmental outcome of the infant.
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