Document Type
Journal Article
Publication Title
Archives of Disease in Childhood: Fetal & Neonatal
Publisher
BMJ Publishing Group
School
School of Nursing and Midwifery
RAS ID
44317
Funders
Theirworld
MRC Centre for Reproductive Health (MRC G1002033)
British Heart Foundation (RE/18/5/34216)
Abstract
Objective:
To determine if preterm birth is associated with adaptation of the hypothalamic–pituitary–adrenal (HPA) axis and whether HPA axis programming relates to the degree of prematurity (defined as extremely preterm birth at < 28 weeks or very preterm birth at 28–32 weeks gestation).
Design:
This study reports findings from a prospective birth cohort. Saliva cortisol concentrations were measured prevaccination and postvaccination, and in the morning and evening, at 4 months chronological age.
Setting:
Infants born at a single Scottish hospital.
Participants:
45 term-born, 42 very preterm and 16 extremely preterm infants.
Outcomes:
Cortisol stress response to vaccination (postvaccination minus prevaccination cortisol concentrations), diurnal slope (log-transformed morning minus log-transformed evening cortisol values) and mean log-transformed daily cortisol.
Results:
Compared with infants born at term, infants born extremely preterm had a blunted cortisol response to vaccination (5.8 nmol/L vs 13.1 nmol/L, difference in means: −7.3 nmol/L, 95% CI −14.0 to −0.6) and a flattened diurnal slope (difference in geometric means: −72.9%, 95% CI −87.1 to −42.8). In contrast, the cortisol response to vaccination (difference in means −2.7 nmol/L, 95% CI −7.4 to 2.0) and diurnal slope at 4 months (difference in geometric means: −33.6%, 95% CI −62.0 to 16.0) did not differ significantly in infants born very preterm compared with infants born at term.
Conclusions:
Infants born extremely preterm have blunted cortisol reactivity and a flattened diurnal slope. These patterns of HPA axis regulation are commonly seen after childhood adversity and could contribute to later metabolic and neurodevelopmental phenotypes observed in this population.
DOI
10.1136/archdischild-2021-321593
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Stoye, D. Q., Boardman, J. P., Osmond, C., Sullivan, G., Lamb, G., Black, G. S., & Reynolds, R. M. (2022). Saliva cortisol diurnal variation and stress responses in term and preterm infants. Archives of Disease in Childhood: Fetal & Neonatal, 107(5), 565-567.
http://dx.doi.org/10.1136/archdischild-2021-321593