Antenatal Thyrotropin-Releasing Hormone to Prevent Respiratory Distress Syndrome in Preterm

Kim, Ai Rhan; Park, Sung Jong; Yoon, Hye Sun; Kim, Ki Soo; Won, Hye Sung; Lee, In Sik; Kim, Ahm; Pi, Soo Young

Abstract

PURPOSE: The purpose of this study was to assess the efficacy of antenatal thyrotropin-releasing hormone(TRH) given to mothers at risk for preterm delivery and assess various neonatal outcomes in infants born to these mothers.
METHODS
Sixty-one mothers(TRH+Dexamethasone(D):30, D:31) with preterm labor at 26-34 weeks of gestational age were randomized into a study group which received 400microgram of TRH at 8 hour interval intravenously(maximum doses of 6) along with 6 mg of D at 12 hour interval intravenously(maximum doses of 4) and into a control group that received the same regimen of D only. Among 61 mothers, 17 mothers(TRH+D:8, D:9) underwent amniocentesis to document changes in L/S ratio and lamellar body count before and after TRH and or D therapy. Thyroid function tests(TFT's) were obtained from infants born at/shortly after birth, near first week and second week of life.
RESULTS
Incidences of respiratory distress syndrome(42% vs 30%) and chronic lung disease(56% vs 44%) were not statistically different between the two groups. In fact, greater risk for ventilation at 28 days was observed in infants born within 24 hours of TRH treatment. All other neonatal outcomes except pulmonary hemorrhage(0% vs. 16%) were similar between TRH+D and D groups. TFT of infants born to mothers who received the last mean duration of TRH at 178 hours were similar between the two groups.
CONCLUSION
Antenatal administration of TRH in addition to D did not have any additional beneficial effects compared to giving D alone.