Neonatology
PRAVEEN BALLABH, MD
Professor
PEDIATRICS
Children Hospital at Montefiore
Bronx, New York, United States
Terrie Inder, MBChB, MD
Chair, Department of Pediatric Newborn Medicine
Brigham and Women's Hospital
Boston, Massachusetts, United States
Hormones are powerful modulators of cell lineage and differentiation. Whereas appropriate exposure can serve as an accelerant to mature organ function in the human fetus and premature infant, they can harm if used inappropriately. Prenatal glucocorticoids differentiate epithelial cell functions of the lung, skin, gut, kidney, eye and CNS and thereby help ensure normal ex utero multiorgan adaptive capacity. While absence of glucocorticoid signals can be detrimental, excessive exposure can induce injury such as brain and hippocampal atrophy. The ubiquitous organ level effects of thyroxine during development are well established and its robust role in brain development is absolute. Yet, animal results did not always translate successfully into effective thyroxine interventions in clinical trials (THOP trial NS045109-01). Although, beneficial results of thyroxine are encouraging in animal models of neonatal brain ischemia and hemorrhage, no neonatal clinical trials exist. The promise of high does erythropoietin on improving neurologic outcomes was unfulfilled (PENUT Trial (NS077953). Estrogen therapy reverses the lost maternal in utero hormonal exposure as evident by its role in neuroprotection during hypoxia. Might these well-defined animal models someday contribute to improving neurodevelopmental outcome of premature infants? This symposium will highlight recent advances from basic, translational, and clinical research to provide a comprehensive update on the risks and benefits of hormonal therapy in premature infants at risk for hypoxia and neurological delays.
Presenter: PRAVEEN BALLABH, MD – Children Hospital at Montefiore
Presenter: Barbara Stonestreet, MD – Women & Infants Hospital/Alpert Med School of Brown University
Presenter: Terrie Inder, MBChB, MD – Brigham and Women's Hospital
Presenter: PRAVEEN BALLABH, MD – Children Hospital at Montefiore
Presenter: Sandra E. Juul, MD, PhD – University of Washington
Presenter: Edmund F. LaGamma, MD, FAAP – NYMC - Maria Fareri Children's Hospital
Presenter: Terrie Inder, MBChB, MD – Brigham and Women's Hospital