Abstract
Objective: To investigate the effect of illness on preterm infant's hypothalamus-putituary-adrenal axis, we measured the concentration of cortisol, aldosterone and ACTH.
Methods: Ninety preterm infants were divided into two groups: gestational age (GA) ≥ 34weeks' and GA< 34weeks'. We measured serum cortisol, aldosterone and ACTH within 72 hours after birth, day 7 and day 14.
Results:
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1)
The serum cortisol concentration on severe illness was higher than that on mild illness. GA≥34weeks', the cortisol concentration on severe illness infants was significantly higher than mild ill infants within 72 hours (t=-2.263, P=0.029). GA< 34 weeks', the cortisol concentration on severe illness infants was significantly higher on the day 14 (t=-2.913, P=0.006).
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2)
The cortisol concentration was significantly decreased on the day 7 and day 14 than that within 72 hours in the GA≥34weeks' (F = 4.679, p = 0.012);
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3)
The cortisol concentration on death infants was significant higher than that on survivors on the day 14.
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4)
When the cortisol concentration was above the 75th, the incidence of mechanical ventilation therapy, glucose metabolism disorder, gastrointestinal hemorrhage, severe periventricular - intraventricular hemorrhage and brain leukomacia, chronic lung disease, and mortality rate were increased strikingly.
Conclusions: The preterm infant already has the ability to response stimuli by regulating cortisol secretion. The cortisol concentration is correlated with the severity of the disease, complications and prognosis.
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Wu, Y., Bo, T., Li, Z. et al. The Effect of Critical Illness on Acth, Cortisol and Aldosterone in Preterm Infants. Pediatr Res 70 (Suppl 5), 754 (2011). https://doi.org/10.1038/pr.2011.979
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DOI: https://doi.org/10.1038/pr.2011.979