Abstract
This study set out to observe changes in adrenal function in infants born prematurely. 22 infants of mean gestation 27.9 weeks and birth wt. 946 g were studied longitudinally between 170-360 days postconceptional age (PCA), by measurements of plasma cortisol (F), cortisone (E), DHEAS, urinary steroid metabolites, and adrenal ultrasound scans (USS).
Mean plasma levels of cortisol (283 nmol 1 :) and cortisone (1353 nmol l−1) at 180-199 days PCA were ten times those reported in the fetus. The low fetal F:E ratio persisted after preterm birth (<1), and even past term (280 days). Mean plasma levels of DHEAS were also similar to fetal values, but fell from 12.3 μmol l−1 at 176 days to <1.0 μmol l−1 at 350 days PCA, being barely detectable after term. Adrenal fetal zone steroids represented 97% of the metabolites in the urine and their excretion remained high (>1200 μg kg−1. d) until term, declining between 280-300 days. Although cortisone metabolites were seen thoughout, cortisol metabolites did not appear until after term. The length of the adrenal gland on USS remained constant. These data suggest maturation in adrenal gland function occurs at term rather than after birth. Changes in adrenal function did not correlate with adrenal length.
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Midgley, P., Holownia, P., Russell, K. et al. ADRENAL FUNCTION IN PRETERM INFANTS. Pediatr Res 33 (Suppl 5), S71 (1993). https://doi.org/10.1203/00006450-199305001-00410
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DOI: https://doi.org/10.1203/00006450-199305001-00410