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Dopamine infusion and anterior pituitary gland function in very low birth weight infants
Luca Filippi1, Marco Pezzati, Alessandra Cecchi
1Neonatal Intensive Care Unit, Department of Critical Care Medicine, University Careggi Hospital, Florence, Italy. filippi.luca@virgilio.it
Insights
Dopamine infusion in very low birth weight infants reduces thyroxine, TSH, and prolactin but not growth hormone. Hormone levels quickly normalize after stopping dopamine, suggesting no long-term pituitary injury.
Area of Science:
- Neonatal endocrinology
- Pediatric pharmacology
Background:
- Dopamine infusion is known to decrease thyroxine (T4), thyroid stimulating hormone (TSH), prolactin (PRL), and growth hormone (GH) in various age groups.
- Understanding these effects in vulnerable preterm infants is crucial.
Purpose of the Study:
- To investigate the impact of dopamine infusion on T4, TSH, PRL, and GH levels in very low birth weight (VLBW) preterm newborns.
- To evaluate the hormonal dynamics during and after dopamine treatment in this population.
Main Methods:
- Prospective observational study involving 97 VLBW infants (<1,500 g).
- Infants were divided into a dopamine-treated group (group B) and a control group (group A).
- Daily blood samples were collected for 10 days to monitor hormone levels during and after dopamine infusion.
Main Results:
- Dopamine infusion led to decreased T4, TSH, and PRL levels, with rapid normalization upon withdrawal.
- Postprandial growth hormone (GH) levels remained relatively stable, showing only a slight, non-significant increase after dopamine cessation.
- Observed hormonal changes were not statistically significant.
Conclusions:
- Dopamine infusion transiently suppresses T4, TSH, and PRL in preterm VLBW infants.
- Dopamine does not significantly affect postprandial GH levels in this cohort.
- The rapid reversal of hormonal suppression suggests dopamine-induced pituitary changes are unlikely to cause long-term harm.
Background:
Previous studies demonstrated that dopamine infusion reduces plasma concentration of thyroxine (T4), thyroid stimulating hormone (TSH), prolactin (PRL), and growth hormone (GH) in adults, children, and infants.
Objectives:
The purpose of this prospective observational study was to evaluate the relationship between dopamine infusion and the dynamics of T4, TSH, PRL, and GH in preterm newborns weighing less than 1,500 g (very low birth weight infants, VLBW) admitted in a neonatal intensive care unit of a university hospital over a one year period.
Methods:
A total of 97 preterm newborns were enrolled and divided into two groups: group B included hypotensive infants treated with plasma expanders and dopamine infusion; group A was the control group including newborns who were never treated with dopamine. The newborns were studied dynamically through blood samples taken every day till 10 days. Newborns of group B were studied during dopamine infusion and after its withdrawal.
Results:
Among the VLBW newborns who were given dopamine, the four pituitary hormones had different dynamics: a reduction of T4, TSH, and PRL levels was noticed since the first day of treatment, and a rebound of their levels was evident since the first day after its interruption. On the contrary, the postprandial GH levels were roughly constant: GH plasma concentrations were in fact a little lower in newborns treated with dopamine, and a slight increase was observed after its withdrawal. However, observed differences were not statistically significant.
Conclusions:
The results suggest that dopamine infusion reduces T4, TSH, and PRL plasma levels in preterm VLBW infants and have no effect on postprandial GH rate. This hormonal suppression reverses rapidly after dopamine withdrawal. This observation suggests that the iatrogenic pituitary suppression probably cannot produce long-term injuries.
