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Current advances in perinatal medicine.

L Stern

    Paediatrician
    |January 1, 1979
    PubMed
    Summary

    Corticosteroids enhance lung maturation to prevent hyaline membrane disease but may impede tissue replication. Vitamin E may prevent oxygen toxicity, and phototherapy converts bilirubin to an excretable form.

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    Area of Science:

    • Neonatal Medicine
    • Pharmacology
    • Biochemistry

    Background:

    • Corticosteroids are clinically used to enhance pulmonary maturation and reduce hyaline membrane disease incidence.
    • Agents enhancing lung maturation may also inhibit tissue replication, posing risks to lung and brain development.
    • Vitamin E (alpha-tocopherol) may prevent oxygen toxicity, including retrolental fibroplasia and bronchopulmonary dysplasia.

    Purpose of the Study:

    • To review the benefits and risks of agents used to enhance pulmonary maturation.
    • To explore the potential role of Vitamin E in preventing oxygen-induced lung injury.
    • To investigate the mechanism of phototherapy in reducing neonatal jaundice.

    Main Methods:

    • Review of experimental and clinical studies on pulmonary maturation agents.
    • Examination of Vitamin E's role as a free radical scavenger.
    • Analysis of recent research on phototherapy's effect on bilirubin metabolism.

    Main Results:

    • Corticosteroids advance lung surfactant system maturation but carry risks of tissue replication arrest.
    • Vitamin E's efficacy in preventing oxygen toxicity is linked to its utilization, not plasma levels.
    • Phototherapy converts unconjugated bilirubin to a water-soluble form, facilitating excretion via the liver and bile ducts.

    Conclusions:

    • The benefits of pulmonary maturation agents must be weighed against potential disadvantages, requiring careful individual assessment.
    • Vitamin E may be crucial for preventing oxygen-related lung and eye damage in premature infants.
    • Phototherapy's mechanism involves light-induced isomerization of bilirubin, suggesting potential for reduced light exposure.

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