Document Detail


Antenatal thyrotropin-releasing hormone to prevent lung disease in preterm infants. North American Thyrotropin-Releasing Hormone Study Group.
MedLine Citation:
PMID:  9468465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Pulmonary disease is common in preterm infants, despite antenatal glucocorticoid therapy. The addition of antenatal thyrotropin-releasing hormone therapy has been reported to decrease pulmonary morbidity in these infants. METHODS: We enrolled 996 women at 13 North American centers who were in preterm labor at <30 weeks' gestation in a double-blind, placebo-controlled, randomized trial of antenatal thyrotropin-releasing hormone, given intravenously in four doses of 400 microg each at eight-hour intervals. The primary outcome was chronic lung disease or death of the infant on or before the 28th day after delivery, and secondary outcomes were respiratory distress syndrome and chronic lung disease or death at 36 weeks' postmenstrual age. Complete data were available for 981 women and their 1134 live-born infants. The 769 infants born at < or = 32 weeks' gestation were defined as the group at risk. RESULTS: There were no significant differences between the at-risk treatment and placebo groups in mean (+/-SD) birth weight (1109+/-354 vs. 1097+/-355 g), gestational age (27.9+/-2.1 vs. 27.9+/-2.1 weeks), sex, or race. The frequencies of respiratory distress syndrome (66 percent vs. 65 percent), death at 28 days (11 percent vs. 11 percent), chronic lung disease or death at 28 days (45 percent vs. 42 percent) and at 36 weeks (32 percent vs. 34 percent), and other neonatal complications as well as the severity of lung disease were not significantly different in the at-risk treatment and placebo groups. Similarly, there were no differences in outcome between the treatment and placebo groups for the infants born at >32 weeks' gestation. CONCLUSIONS: In preterm infants at risk for lung disease, antenatal administration of thyrotropin-releasing hormone and glucocorticoid is no more beneficial than glucocorticoid alone.
Authors:
R A Ballard; P L Ballard; A Cnaan; J Pinto-Martin; D J Davis; J F Padbury; R H Phibbs; J T Parer; M C Hart; F L Mannino; S K Sawai
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  338     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1998 Feb 
Date Detail:
Created Date:  1998-02-19     Completed Date:  1998-02-19     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  493-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Pediatrics, University of Pennsylvania School of Medicine and Children's Hospital of Philadelphia, 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Chronic Disease
Dexamethasone / therapeutic use
Double-Blind Method
Drug Therapy, Combination
Female
Glucocorticoids / therapeutic use
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / prevention & control*
Lung Diseases / prevention & control*
Male
Obstetric Labor, Premature
Pregnancy
Prenatal Care*
Respiratory Distress Syndrome, Newborn / prevention & control
Thyrotropin-Releasing Hormone / administration & dosage,  adverse effects,  therapeutic use*
Treatment Outcome
Grant Support
ID/Acronym/Agency:
MO1-RR00040/RR/NCRR NIH HHS; MO1-RR000425/RR/NCRR NIH HHS; R01-HD29201/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Glucocorticoids; 24305-27-9/Thyrotropin-Releasing Hormone; 50-02-2/Dexamethasone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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