The neonates in this study were divided into 2 groups: patients group which
included (48) neonates with respiratory distress (RD) they were divided into (6) sub
groups according to the cause of (RD), respiratory distress syndrome (K.D.,S)
meconium aspiration syndrome (MA.S.), pneumonia, hypoxic ischemic
encephalopathy (HIE),transient tachypnea of the newborn (TTN), polycythemia and
control group which included (19) full term healthy neonates delivered by
spontaneous vaginal delivery (s.V.D). Blood samples were collected and plasma
endorphin and serum cortisol were estimated by radioimmunoassay.
This study revealed that the studied parameters were affected in all patients
of respiratory difficulties as regards respiratory rate and heart rate (R.R and HR).
They were higher in patients than control but as regards body weight it was
significantly decreased (P < 0.001). Also some blood gases (pH, 02 saturation and
Hco3) were lower in patients than the control group where distressed neonates
developed hypoxia and acidosis (often mixed type). The present study revealed that in
distressed neonates, haematological parameters (HB, Hematocrite value (Hct 10 and
RBCs) were significantly higher in patients than control cases. Plasma betaendorphin
level was higher in patients than control group (P < 0.01), but in
comparison of different subgroups of patient to each other, there was no significant
dWerence. Also serum cortisol level was higher in patients than the control group but
intra group comparison to each other, there was no significant difference. However,
blood glucose level showed significant decrease in patients than control group.
Moreover, in patient's group, there was significant positive (P<0.001) correlation
between I3-endorphin and cortisol.
We can conclude that respiratory difficulty ,regardless the cause, is associated
with increase beta endorphin and cortisol secretion to face this stressful situation. So
exogenous use of opioids by physiological dose may be beneficial. Minimal handling
of neonates specially distressed ones sedatives and pain relief agents must be used in
the physiological doses in stressful situations. Further studies are needed to find the
actual beneficial doses and to explore the maternofetal transplacental passage of
opioids (fl.E)ftom mother to fetus. |
