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

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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