Abstract
Definitive and fetal adrenocortical functions were studied in 8 preterm (PT) adequate for gestational age (AGA), in 10 PT small for gestational age (SGA) neonates during the first 14 days of postnatal life and in 8 full term (FT)AGA newborns during the first 7 days of Postnatal life. Peripheral vein serum cortisol and 17γ - hydroxyprogesterone (17-OH-P) were used as parameters of the function of the definitive zone while serum dehydroepian-drosterone sulfate (DS) as indicator of fetal zone function of the adrenal cortex. Cord vein blood (CVB) serum 17-OH-P was used as a marker of the function of the fetoplacental unit. There was a significant negative correlation between 1-day-old and 5-day-old serum 17-OH-P, cortisol or DS and gestational age in the 27 subjects studied. A significant negative correlation was found between serum 17-OH-P and days of postnatal life in the 3 groups of neonates, and between serum cortisol and days of postnatal life in PTAGA neonates but not in PT SGA newborns. During the first week of life, mean±SD serum cortisol was 267 ± 143 and 273 ± 136 nmol/l in PT AGA and PT SGA neonates respectively (p < 0.05 and p < 0.02), significantly higher than in FT newborns (118 ± 81). Serum 17-OH-P was higher (p < 0.05) in PT AGA neonates only (8.77 ± 6.6 vs 3.60 ± 2.81 nmol/lt in FT). Serum 17-OH-P was lower in cord vein blood of PT, as well as in maternal blood during delivery, compared to that of FT (67 ± 86 vs 341 ± 182 nmol/l, p < 0.01). Increased levels of cortisol and 17-OH-P in PT newborns suggest that the stimulus of the extra uterine adaptation in prematurity results in adequate response of the definitive zone of the adrenal cortex. This increased serum 17-OH-P present in PT neonates should be considered in the differential diagnosis of 21-hydroxylase deficiency.
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Nizzo, D., Warman, M., Chaler, E. et al. ADRENOCORTICAL FUNCTION IN ADEQUATE AND SMALL FOR GESTATIONAL AGE PREMATURE NEONATES DURING THE FIRST TWO WEEKS OF LIFE. Pediatr Res 28, 557 (1990). https://doi.org/10.1203/00006450-199011000-00035
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DOI: https://doi.org/10.1203/00006450-199011000-00035