Altered basal cortisol levels at 3, 6, 8 and 18 months in infants born at extremely low gestational age.

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Abstrakt

Tytuł:: Altered basal cortisol levels at 3, 6, 8 and 18 months in infants born at extremely low gestational age.
Autorzy:: Grunau RE; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. />Haley DW
Whitfield MF
Weinberg J
Yu W
Thiessen P
Źródło:: The Journal of pediatrics [J Pediatr] 2007 Feb; Vol. 150 (2), pp. 151-6.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: St. Louis, MO : Mosby
MeSH Terms:: Infant, Extremely Low Birth Weight*
Infant, Very Low Birth Weight*
Child Development/*physiology
Hydrocortisone/*metabolism
Age Factors ; Apgar Score ; Case-Control Studies ; Female ; Follow-Up Studies ; Gestational Age ; Humans ; Hydrocortisone/analysis ; Infant ; Infant, Newborn ; Intensive Care Units, Neonatal ; Male ; Probability ; Reference Values ; Risk Factors ; Sex Factors ; Term Birth ; Time Factors
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Grant Information:: R01 AA007789 United States AA NIAAA NIH HHS; R01 HD039783 United States HD NICHD NIH HHS; HD39783 United States HD NICHD NIH HHS
Substance Nomenclature:: WI4X0X7BPJ (Hydrocortisone)
Entry Date(s):: Date Created: 20070124 Date Completed: 20070207 Latest Revision: 20181113
Update Code:: 20240104
PubMed Central ID:: PMC1851896
DOI:: 10.1016/j.jpeds.2006.10.053
PMID:: 17236892
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Objective: Little is known about the developmental trajectory of cortisol levels in preterm infants after hospital discharge.
Study Design: In a cohort of 225 infants (gestational age at birth <33 weeks) basal salivary cortisol levels were compared in infants born at extremely low gestational age (ELGA, 23-28 weeks), very low gestational age (29-32 weeks), and term (37-42 weeks) at 3, 6, 8, and 18 months corrected age (CA). Infants with major neurosensory or motor impairment were excluded.
Results: At 3 months CA, salivary cortisol levels were lower in both preterm groups compared with the term infants (P = .003). Conversely, at 8 and 18 months CA, the ELGA infants had significantly higher basal cortisol levels than the very low gestational age and term infants (P = .016 and P = .006, respectively).
Conclusions: In ELGA infants, the shift from low basal cortisol levels at 3 months to significantly high levels at 8 and 18 months CA suggests long-term "resetting" of endocrine stress systems. Multiple factors may contribute to these higher cortisol levels in the ELGA infants, including physiological immaturity at birth, cumulative stress related to multiple procedures, and mechanical ventilation during lengthy hospitalization. Prolonged elevation of the cortisol "set-point" may have negative implications for neurodevelopment and later health.

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