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Published on: November 20, 2015
[Potential consequences of the sudden postnatal drop of estrogen levels in preterm neonates]
Péter Tóth1, Gábor Erdei, Barna Vásárhelyi
1Semmelweis Egyetem Altalános Orvostudományi Kar, I. Gyermekklinika, és Gyermekgyógyászati és Nefrológiai Kutatócsoport, Magyar Tudományos Akadémia, Budapest.
Insights
Estrogen supplementation may reduce risks of bronchopulmonary dysplasia and osteopenia in premature infants. Further research is needed to confirm the safety and effectiveness of this neonatal hormone therapy.
Area of Science:
- Endocrinology and Neonatology
- Reproductive Biology
- Pediatric Physiology
Context:
- Estrogens exert significant extragenital effects, impacting fetal development and homeostasis.
- Premature infants often experience complications linked to abrupt withdrawal of in utero estrogen exposure.
- These complications include reduced uterine volume, elevated atherogenic lipids, osteopenia, and inflammatory issues.
Purpose:
- To evaluate the physiological effects of estrogen and progesterone supplementation in premature infants.
- To investigate the potential of hormone therapy to mitigate adverse outcomes in preterm neonates.
Summary:
- A pilot study assessed estrogen and progesterone supplementation in premature infants.
- Preliminary findings suggest a potential reduction in bronchopulmonary dysplasia and osteopenia among treated infants.
- The study highlights the need for further investigation into the efficacy and long-term safety of estrogen supplementation for preterm neonates.
Impact:
- Provides preliminary evidence for the therapeutic potential of estrogen supplementation in neonatal care.
- Identifies key areas for future research regarding hormone therapy in preterm infants.
- Contributes to understanding the role of estrogens in neonatal development and disease prevention.
Abstract:
Estrogens have profound effects on bone- and lipid homeostasis, modulate immune functions and play a major role in the regulation of the development and function of central nervous system, cardiovascular system and respiratory system. They induce hepatic protein production. There is a strong connection between estrogens and several hormone systems including growth hormone--IGF axis and renin-angiotensin system. The extragenital effects of estrogens are probably more evident in the fetus than in fertile women. However, direct data are not available because of the lack of estrogen-deficient pregnancy models. Theoretically, in immature infants the premature cessation of in utero high estrogen levels is associated with the progression of perinatal acute complications. The volume of uterus in female premature infants is lower than in term newborns, the plasma levels of atherogen lipids are high, osteopenia due to inadequate bone acquisition is frequent. Inflammatory complications are common. Recently, the physiological effects of estrogen- and progesterone supplementation of premature infants have been evaluated in a pilot study. The preliminary results indicate, that the risk of bronchopulmonary dysplasia, osteopenia might be decreased in treated infants. Further studies are needed to confirm the effectivity and long term safety of estrogen supplementation of preterm neonates.
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