Der Einfluss von Östradiol und Progesteron auf die Nasenpotenzialdifferenz von Frühgeborenen

Abstract

Postnatal supplementation of estradiol (E2) and progesterone (P) in preterm infants may improve lung function, possibly mediated through enhanced epithelial Na+ transport. Preterm infants of < 29 week gestational age and < 1000g birth weight needing mechanical ventilation within 12 hours of birth were randomized to receive 2,5 mg/kg E2 and 22,5 mg/kg P per day or placebo. Nasal potential difference (NPD) and amilorid-sensitive NPD (ASNPD) as amount of epithelial Na+ transport was measured in 29 infants on postnatal day of life 1, 3, 5 and 7. Mean values of all four measurements were calculated. Mean ASNPD was 6,5 ± 2,8 mV in infants receiving E2/P and 6,1 ± 2,6 mV in infants receiving placebo (not significant). NPD was -10,0 ± 3,8 mV and -10,3 ± 3,6 mV. The ASNPD was significant higher in infants surviving without bronchopulmonal dysplasia, defined as need for supplemental oxygen or mechanical ventilation at 36 weeks postmenstrual age for SaO2 90 % (7,1 ± 2,6 mV) than in infants developing BPD or dying. In conclusion, postnatal replacement of E2 and P does not change ASNPD, but infants surviving without BPD had higher ASNPD values in the first week of life.