The relationship between serum levels of prolactin and growth hormone in the early postnatal period.

BackgroundIn the neonatal period, the pituitary hormones including prolactin (PRL) and human growth hormone (hGH) are secreted in high amounts due to immature feedback mechanisms. As both hormones are secreted in part by the same somatomammotrophic cells, we investigated their relationship in newborns with respect to sex, gestational week, method of delivery, and anthropometric data.MethodsThe serum levels of PRL and hGH were measured in blood drawn from 225 newborns. The newborn data were extracted from medical records.ResultsA positive correlation was found between log-transformations of PRL and hGH (r=0.17; P=0.01; n=225), with a stronger correlation in newborns whose blood samples were taken more than 2 days after birth (r=0.42; P<0.001; n=130). Log-transformations of the PRL/hGH ratio demonstrated a positive correlation with the gestational week (r=0.39; P<0.001; n=200). Multiple regression analysis showed that 15% of the variance in the logarithm of this ratio is attributed to the gestational week.ConclusionIn newborns, serum PRL and hGH levels show a positive correlation that can be explained by common regulatory factors or a drift phenomenon. A higher gestational week is associated with a higher PRL/hGH ratio. Further studies are needed to look for possible confounders and to determine the PRL-hGH relationship in different conditions.

Colchicine use during breastfeeding.

OBJECTIVE: This study evaluated the outcome of infants exposed to colchicine during lactation. SUBJECTS AND METHODS: A prospective observational cohort study design was used. Mothers who contacted Beilinson Teratology Information Service (BELTIS) regarding use of colchicine while breastfeeding were followed up by phone interview. Data on lactation, neonatal symptoms, and outcome 1-3 years after initial consultation were obtained. Mothers breastfeeding while taking colchicine (n=37) and their infants (n=38) were compared with a matched control group of mothers using a drug known to be safe during lactation (n=75) and their infants (n=76). RESULTS: Follow-up was obtained for 59 of 76 (78%) women who contacted BELTIS regarding use of colchicine. Of the 59 women, 37 breastfed while taking colchicine, five did not take colchicine, 16 did not breastfeed, and one declined to participate. The mean duration of breastfeeding was similar in both groups. Adverse neonatal symptoms were seen in three of 38 colchicine-exposed infants versus four of 76 of control group infants (p=0.68). Delayed development or neurological abnormalities were seen in two infants in both study groups (p=0.60). None of the colchicine-exposed infants showed abnormal growth. CONCLUSIONS: No increase in adverse long-term outcomes was found in colchicine-exposed breastfed infants. Our data support continuation of breastfeeding in women treated with colchicine.

Management of term newborns following maternal intrapartum fever.

OBJECTIVE: To evaluate the diagnostic and therapeutic approach to full term neonates born to mothers with intrapartum fever. METHODS: In a retrospective study, neonates born to mothers with intrapartum fever, (≥ 37.8°C), were compared to control group matched by gestational age and birthweight. RESULTS: Overall, 159 singleton full term neonates born to women with intrapartum fever (study group) were compared to 159 control infants. No differences in neonatal outcomes were found between the two groups except for a higher rate of meconium-stained amniotic fluid in the maternal-fever group. There were no cases of neonatal infection, severe neonatal morbidity, or neonatal mortality in either of the groups. Full sepsis workup and intravenous antibiotic treatment were provided to 17.6% of the neonates in the study group. Logistic regression analysis revealed that delivery by Cesarean section was the only factor independently associated with the decision to perform a full sepsis work up and antibiotic treatment in cases of maternal intrapartum fever (OR 32.0, 95% CI 9.4-112.1). CONCLUSIONS: In low-risk women with asymptomatic intrapartum fever, neonatal infection is uncommon, so that aggressive evaluation and management of these infants may not be necessary and should be balanced against the low risk of neonatal sepsis.