Cortisol Levels in Healthy Term and Preterm Appropriate for Gestation Infants

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Cortisol Levels in Healthy Term and Preterm Appropriate for Gestation Infants

Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 8

Abstract

Introduction: Cortisol levels in term and preterm neonates are affected by various factors namely gestational age, postnatal age, sickness and antenatal steroids. There is no normative data on cross-sectional values of serum cortisol levels in preterm babies at various gestations. Previous studies have been on longitudinal data based on postnatal age. Study objective was to study cortisol levels in healthy term and preterm appropriate for gestation infants at various gestations. Material and Methods: This Prospective observational study was done in Gitam Institute Of Medical Sciences and Research Institute and Omni Rk hospital Visakhapatnam in a level lll neonatal unit. Only appropriate for gestation and healthy Preterm neonates > 30 weeks of gestation and term neonates >37 weeks of gestation were included. Babies were stratified in to four groups i) 30-32 weeks (group 1), ii) 33-34 weeks (group 2), iii) 35-36 weeks (group 3) and > 37 weeks were taken in the term category (group 4). Outcomes: The primary outcome measures were mean, median and 10th and 90th centile values of the serum cortisol levels in healthy preterm and term AGA neonates on day 3 and on day 7. Secondary outcome measures were effect of various peripartum factors on cortisol levels. Results: Of the total 86 babies included, 21 babies were there each in-group 1, 2 and 4, and 23 babies in-group 3 and cortisol estimation was done. The mean cortisol value was lowest on day 3 (295+184 nmol/L) and day 7 (221+155 nmol/L) in term babies as compared to 3 preterm subgroups (303+202 nmol/L, 310+196 nmol/L, 316+274 nmol/L on day 3 and 359+268 nmol/L, 280+210 nmol/L, 228+236 nmol/L on day 7 in group 1,2 and 3 respectively.) In all groups mean and median cortisol levels showed a declining trend from day 3 to day 7 except in group 1 where the mean cortisol level increased from day 3 to day 7 though this increase was not statistically significant. The increase in cortisol level on day7 was also seen in the preterms who received antenatal steroids vs no steroid (291+197 nmol/L and 329+251 nmol/L on day 3 and day 7 vs 362+212 nmol/L and 282+250 nmol/L on day 3 and day 7 respectively). Conclusions: In neonates the cortisol levels were inversely related to gestational age and showed a progressive decline from day 3 to day 7 however in preterm babies who received antenatal steroid this effect was altered. Amongst perinatal factors, prolonged rupture of membrane had highest cortisol level.

Authors and Affiliations

Koripadu Seshagiri, Yanamandala Venkata Harischandra

Keywords

Cortisol Levels Antenatal Steroid

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