We described higher cortisol in preterm infants who required neither surfactant (S) nor inotropes (I). A need for both these therapies maybe a marker of low cortisol but were used in 70% of the preterm infants studied.

Other factors that have been demonstrated singly to be correlated to cortisol concentrations were added in a model with gestational age (GA)(1=24-27, 2=28-31, 32-36 wks) using ANOVA with added cofactors. Only weight gain (W) during week one was significant in the model which included S plus I.Figure

figure 1

Figure 1

Results: 285 infants were separated into two acuity groups (S+I+W=â—‹, 30% of total) versus all other combinations = â–ª. 1). Cortisol correlated to GA (F=10.41, p=0.0001) and to acuity group (F=16.99, p=0.0001). 2) Oxygen(36 wks) (p<0.01) and mortality (p=0.02) were likely in â—‹. 3) Cortisol was < for â—‹ in GA groups 2 and 3 (p<0.05 for each group). In sum: Acuity groups were different for mortality, O2 needs and cortisol values. We suggest there is a high risk group with low cortisol values and increased mortality and morbidity.