Gunn A J, Gunn T R, Rabone D L, Breier B H, Blum W F, Gluckman P D
Department of Paediatrics, Auckland School of Medicine, University of Auckland, New Zealand.
Pediatrics. 1996 Aug;98(2 Pt 1):279-82.
To determine the galactopoietic response to recombinant human growth hormone (hGH) in mothers of premature infants with inadequate lactation.
Prospective placebo-controlled, double-blind trial.
Twenty healthy mothers on no concurrent medication, with infants born between 26 and 34 weeks' gestation with insufficient milk production for their infants' needs.
Ten mothers received hGH, .2 IU/kg/day subcutaneously to a maximum of 16 IU/day, for 7 days, while 10 mothers received the same volume of placebo. One mother from each group withdrew from the study.
Maternal milk production and plasma concentrations of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), and growth hormone (GH) were determined before starting treatment and 1 day after stopping therapy. A nurse measured the amount of milk expressed (5 to 6 times daily) plus, if the infant was suckling, weighed the infant before and after feeding.
The mothers were enrolled 35 +/- 26 days after birth; at this time the infants weighed 1.89 +/- .64 kg. Milk production in hGH-treated mothers increased from 139 +/- 49 mL/day to 175 +/- 46 mL/day after 7 days of treatment (a rise of 31%). Placebo-treated mothers showed no significant change from 93 +/- 50 mL/day to 102 +/- 69 mL/day (a rise of 7.6%, not significant). Milk production increased in all treated mothers but decreased in 4 of 9 placebo mothers. Plasma concentrations of IGF-1 and IGFBP-3 increased in hGH-treated mothers but not placebo-treated mothers; there was no change in plasma GH levels in either group. No adverse effects were seen with hGH treatment in the mothers or infants.
hGH therapy in mothers with lactational insufficiency can improve breast milk volumes.
确定重组人生长激素(hGH)对泌乳不足的早产儿母亲的催乳作用。
前瞻性安慰剂对照双盲试验。
20名未同时服用其他药物的健康母亲,其婴儿出生时孕周为26至34周,母乳产量不足以满足婴儿需求。
10名母亲接受hGH皮下注射,剂量为0.2 IU/kg/天,最大剂量为16 IU/天,共7天;另外10名母亲接受相同体积的安慰剂。每组各有一名母亲退出研究。
在开始治疗前及停止治疗1天后,测定母亲的母乳产量以及血浆胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)和生长激素(GH)的浓度。一名护士测量挤奶量(每天5至6次),如果婴儿进行母乳喂养,则在喂奶前后对婴儿称重。
母亲们在婴儿出生后35±26天入组;此时婴儿体重为1.89±0.64千克。接受hGH治疗的母亲在治疗7天后,母乳产量从139±49毫升/天增加到175±46毫升/天(增加了31%)。接受安慰剂治疗的母亲母乳产量从93±50毫升/天增加到102±69毫升/天(增加了7.6%,无统计学意义)。所有接受治疗的母亲母乳产量均增加,但9名接受安慰剂治疗的母亲中有4名母乳产量下降。接受hGH治疗的母亲血浆IGF-1和IGFBP-3浓度升高,而接受安慰剂治疗的母亲则无变化;两组母亲血浆GH水平均无变化。hGH治疗对母亲或婴儿均未观察到不良反应。
对泌乳不足的母亲进行hGH治疗可增加母乳量。