[The wonderful world of steroid hormones in neonatology - the first 50 years].

Abstract

Professor László Karmazsin established the contemporary neonatal intensive care at the Department of Pediatrics of the University of Debrecen. His research group’s achievements in the field of neonatal immunobiology contributed to advances in perinatology. Investigating the antioxidant system in neonates, he and his group played a major role in uncovering the pathomechanisms of conditions associated with prematurity. At the same time, corticosteroids, applied as antenatal prophylaxis, and another, endogenous steroid hormone, active vitamin D, have also been shown to significantly impact fetal development and perinatal morbidity. Professor Karmazsin’s group pointed out to the relevance of corticosteroid receptors in mediating the effects of the hormone both in type II alveolar cells of neonates, as well as in leukemic cells. In this publication, we performed a literature review to analyze the interactions of these two steroid hormones on outcome results of the management of premature infants. Additionally, we report the results of a cohort study performed in the Neonatal Intensive Care Unit of the Department of Pediatrics of the University of Debrecen. In the presented small-sample study (n: 37), which focused on very low birth weight preterm infants, we examined the potential correlations between insufficient 25(OH)D levels and neonatal morbidities. In the group of preterm infants with insufficient (<50 nmol/L) 25(OH)D levels (N: 6/37) compared to those with sufficient (50–75 nmol/L) or optimal (>75 nmol/L) 25(OH)D levels (n: 31/37), higher incidences were observed in early (1/6 vs. 0/31; p: 0.021) and late (1/6 vs. 1/31; p: 0.183) neonatal infections, bronchopulmonary dysplasia (3/6 vs. 8/31; p: 0.235), necrotizing enterocolitis (1/6 vs. 1/31; p: 0.183), and the severe form of retinopathy of prematurity (1/6 vs. 0/31; p: 0.060). The difference was statistically significant in the case of early infections. Our results should be evaluated considering the limiting role of the small sample size. Orv Hetil. 2025; 166(12): 443–449.