Altered Basal Cortisol Levels at 3, 6, 8 and 18 Months in Infants Born at Extremely Low Gestational Age - 12/08/11
, David W. Haley, PhD, Michael F. Whitfield, MD, Joanne Weinberg, PhD, Wayne Yu, BSc, Paul Thiessen, MD
Reprint requests: Dr. Ruth E. Grunau, L408 Centre for Community Child Health Research, 4480 Oak St, Vancouver, B.C. V6H 3V4, Canada.Résumé |
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.
Le texte complet de cet article est disponible en PDF.Abbreviations : AGA, CA, ELGA, GA, HPA, IV, NICU, VLGA
Plan
| Supported by the National Institute for Child Health and Human Development grant HD39783, with additional funding from the Canadian Institutes for Health Research grant MOP42469, the Human Early Learning Partnership (HELP grants 02-2410 JW and 03-3112 REG), and the Michael Smith Foundation for Health Research (REG). |
Vol 150 - N° 2
P. 151-156 - février 2007 Retour au numéro
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