Table of Contents
Advances in Endocrinology
Volume 2014 (2014), Article ID 973184, 4 pages
http://dx.doi.org/10.1155/2014/973184
Research Article

Is Dopamine an Iatrogenic Disruptor of Thyroid and Cortisol Function in the Extremely Premature Infant?

1Department of Women’s and Children’s Health, Institute of Translational Medicine, University of Liverpool, Liverpool Women’s Hospital, Crown Street, Liverpool L87SS, UK
2Department of Paediatrics, Southport and Ormskirk NHS Trust, Wigan Road, Ormskirk L39 2AZ, UK
3Department of Biochemistry, Alder Hey Children’s Foundation Trust, Eaton Road, Liverpool L12 2AP, UK

Received 6 April 2014; Revised 24 May 2014; Accepted 26 May 2014; Published 4 June 2014

Academic Editor: Wayne Brake

Copyright © 2014 Sze M. Ng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Dopamine is frequently used as an inotropic and vasoactive agent in neonatal intensive care units. Recent studies have reported that treatment with dopamine is associated with hypothyroxinaemia of prematurity. Objectives. The aim of this study was to determine if dopamine treatment in extremely premature infants altered thyroid and cortisol function. Methods. We prospectively measured plasma cortisol, TSH, free T4, total T4, and free triiodothyronine concentrations in babies born below 28 weeks’ gestation within 5 days of birth, who were either treated with dopamine (D+) or who did not receive any dopamine (D−) within 12 hours of birth. Clinical Risk Index for Babies scores, lowest mean arterial pressure and highest plasma lactate concentrations in the first 12 hours, were recorded. Results. There were 78 babies included in the study (43 males). Mean gestational age was 25 weeks and 3 days (SD 1.3 weeks). Univariate analyses showed significant differences in cortisol and thyroid function between D+ and D−. Multivariable analyses showed that dopamine, gestation, and CRIB were independent factors affecting FT4 concentrations. No independent factors were shown to affect cortisol or TSH concentrations. Conclusion. Dopamine administration appeared to affect FT4 concentrations but not cortisol concentrations. The mechanisms are unclear but the effect does not appear to be related to hypotension or tissue underperfusion.