Geç preterm ve term yenidoğanlarda yenidoğanın geçici takipnesi gelişimi ile kortizol, epinefrin ve tiroid hormonları düzeyleri arasındaki ilişki
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Date
2020-09-26
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Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada yenidoğan geçici takipnesi tanısı alan term ve geç preterm yenidoğanlarla, kontrol grubunda kortizol, epinefrin, serbest T4 (sT4), serbest T3 (sT3) ve tiroid stimülan hormon (TSH) serum düzeylerini belirlemeyi; yenidoğanın geçici takipnesi (YGT) gelişimiyle bu stres hormon düzeyleri arasındaki ilişkiyi saptamayı amaçladık. YGT tanısı alan term (n: 25), geç preterm (n: 20) hasta ile kontrol (n: 45) grubu olmak üzere toplam 90 yenidoğan çalışmaya alındı. Gestasyonel hafta, doğum şekli (elektif sezaryen (C/S), eylemli C/S, vajinal), cinsiyet, doğum ağırlığı, Apgar skorları ve anneye ait özellikler kaydedildi. Hastalardan postnatal 18.-24 saatler arasında serum kortizol, epinefrin, sT4, sT3 ve TSH hormon düzeyleri için kan örnekleri alındı. Gruplar arasında demografik özellikler açısından fark yoktu, elektif C/S grubunda YGT gelişme riski yüksek saptandı. Hasta (term+geç preterm) grubunda kontrol grubuna göre serum kortizol seviyelerinde istatiksel olarak fark saptanmadı; sT4 ve sT3 seviyeleri benzer olarak bulundu. TSH ve epinefrin düzeyleri ise YGT tanılı yenidoğan grubunda anlamlı düşük bulundu. Geç preterm hasta grubunda kontrol grubuna göre kortizol, epinefrin, TSH hormon seviyeleri düşükken; sT3 sT4 seviyelerinin benzer olduğu saptandı. Term hasta grubuyla kontrol grubu hormon seviyeleri arasında anlamlı fark saptanmadı Çalışmamızda; YGT tanılı grupta, kontrol grubuna göre TSH, epinefrin düzeyleri düşük saptanmış ancak literatürden farklı olarak gruplar arasında kortizol, sT3 ve sT4 düzeylerinde fark bulunmamıştır. Bu sonuçlarla; TSH ve epinefrinin fetal akciğer sıvı emilimi ile postnatal pulmoner adaptasyon mekanizmasını düzenlemede etkili olabileceğini düşünmekteyiz
In this study, we aimed to define the serum levels of cortisol, epinephrine, free T4 (fT4), free T3 (fT3) and thyroid stimulating hormone (TSH) in term and late preterm newborns with TTN and control group; to determine the relationship between the development of TTN and these stress hormone levels. 90 newborns, including term (n: 25), late preterm (n: 20) patient diagnosed of TTN and control group (n: 45), were included in the study. Gestational week, type of delivery (elective cesarean section(C/S), activated C/S, vaginal), gender, birth weight, Apgar scores and maternal characteristics were recorded. Blood samples were obtained from the patients for serum cortisol, epinephrine, fT4, fT3 and TSH hormone levels between 18.- 24. hours postnatally. There was no difference in demographic characteristics between the groups (p> 0.05), and the risk of developing TTN was determined highly in the elective C/S group (p <0.05). Although serum cortisol levels there was no statistically significant difference; the sT4 and sT3 levels were similar. TSH and epinephrine levels were significantly lower in the newborn group diagnosed with TTN (p <0.05). Altough cortisol, epinephrine and TSH hormone levels were lower in the late preterm patient group compared to the control group (p <0.05); sT3 sT4 levels were found to be similar (p> 0.05). There was no significant difference between term patient group and control group hormone levels (p> 0.05). In our study;In our study; when the group diagnosed with TTN was compared with the control group, TSH and epinephrine levels were found to be low, but unlike the literature, there was no difference in the levels of cortisol, fT3 and fT4. With these results; we think that TSH and epinephrine may be effective in regulating fetal lung fluid absorption and postnatal pulmonary adaptation mechanism.
In this study, we aimed to define the serum levels of cortisol, epinephrine, free T4 (fT4), free T3 (fT3) and thyroid stimulating hormone (TSH) in term and late preterm newborns with TTN and control group; to determine the relationship between the development of TTN and these stress hormone levels. 90 newborns, including term (n: 25), late preterm (n: 20) patient diagnosed of TTN and control group (n: 45), were included in the study. Gestational week, type of delivery (elective cesarean section(C/S), activated C/S, vaginal), gender, birth weight, Apgar scores and maternal characteristics were recorded. Blood samples were obtained from the patients for serum cortisol, epinephrine, fT4, fT3 and TSH hormone levels between 18.- 24. hours postnatally. There was no difference in demographic characteristics between the groups (p> 0.05), and the risk of developing TTN was determined highly in the elective C/S group (p <0.05). Although serum cortisol levels there was no statistically significant difference; the sT4 and sT3 levels were similar. TSH and epinephrine levels were significantly lower in the newborn group diagnosed with TTN (p <0.05). Altough cortisol, epinephrine and TSH hormone levels were lower in the late preterm patient group compared to the control group (p <0.05); sT3 sT4 levels were found to be similar (p> 0.05). There was no significant difference between term patient group and control group hormone levels (p> 0.05). In our study;In our study; when the group diagnosed with TTN was compared with the control group, TSH and epinephrine levels were found to be low, but unlike the literature, there was no difference in the levels of cortisol, fT3 and fT4. With these results; we think that TSH and epinephrine may be effective in regulating fetal lung fluid absorption and postnatal pulmonary adaptation mechanism.
Description
Keywords
Yenidoğanın geçici takipnesi, Transient tachypnea of newborn, Epinefrin, Kortizol, Tiroid hormonu, Epinephrine, Cortisole, Thyroid hormone
Citation
Özkılınç, C. M. ve Yalınbaş, E. E. (2020). "Geç preterm ve term yenidoğanlarda yenidoğanın geçici takipnesi gelişimi ile kortizol, epinefrin ve tiroid hormonları düzeyleri arasındaki ilişki". Bursa Uludağ Üniversitesi Güncel Pediatri, 18(3), 358-369.