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Neonatologie Scan 2018; 07(02): 135-146
DOI: 10.1055/a-0527-2653
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© Georg Thieme Verlag KG Stuttgart · New York

Die Sexualsteroide Östradiol und Progesteron – eine neue Therapieoption für Frühgeborene?

Andreas Trotter
Subject Editor: Wissenschaftlich verantwortlich gemäß Zertifizierungsbestimmungen für diesen Beitrag ist Prof. Dr. med. Andreas Trotter, Singen.
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Publication History

Publication Date:
29 May 2018 (online)

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Während der Schwangerschaft produziert die Plazenta steigende Mengen an Östradiol (E2) und Progesteron (P), denen auch der Fetus ausgesetzt ist. Nach der Geburt kommt es zu einem rapiden Konzentrationsabfall beider Steroide bei Mutter und Kind. Welche Auswirkungen dieser relative Mangel an E2 und P für Frühgeborene hat, ist nicht bekannt. Es gibt Hinweise dafür, dass beide Hormone für die Entwicklung bedeutend sind.
Kernaussagen

  • Während der Schwangerschaft steigen die Plasmakonzentrationen von E2 und P bei der Mutter bis um den Faktor 100 an, denen auch der Fetus ausgesetzt ist.

  • Nach der Geburt kommt es durch Wegfall der Plazenta innerhalb weniger Stunden zu einem rapiden Abfall der E2- und P-Plasmakonzentrationen bei Mutter und Kind.

  • Sehr kleine Frühgeborene sind viele Wochen von der E2- und P-Versorgung durch die Plazenta abgeschnitten.

  • Es gibt viele Hinweise aus der Literatur, dass E2 und P für sehr kleine Frühgeborenen im Hinblick auf die Knochenmineralisierung, Lungenfunktion und neurologische Entwicklung bedeutend sein könnten.

  • Bisherige Studien zu einer postnatalen Substitution von E2 und P bei sehr kleinen Frühgeborenen konnten interessante Trends für ein besseres Outcome aufzeigen.

Schlüsselwörter

Östrogene - Östradiol - Progesteron - fetal - Frühgeborene - Substitution
 

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