Abstract
Background: Controversy exists whether early adrenal insufficiency is present in preterm infants (PIs) or not. Urinary cortisol production rates (CPRs) provides an integrated index of adrenal function. The aim of this prospective study was to compare CPRs between well and ill PIs< 30 weeks gestational age.
Methods: PIs were classified according to clinical criteria and the score for neonatal acute physiology (SNAP). All major neonatal glucocorticoid metabolites (GMs) (n= 14) were profiled by gas chromatography-mass spectrometry in 24-h urinary samples. Excretion rates of GMs were summed to calculate CPRs (μg/kg/d/mg creatinine). We developed an own non invasive urine collection procedure using specially manufactured cellulose nappies and extraction by hydraulic press.
Results: CPRs were determined in 17 well (27.9 ± 1.8 wk; 1078 ± 321g) and 44 ill (27.3 ± 1.6; 984 ± 257) PIs. Medians of SNAP and CPRs of ill (well) PIs were given in the table, p< 0.051.
During the observational period SNAP and CPRs behaved inversely in ill PIs. CPRs were not different in ill vs well PIs during critical illness.
Conclusion: Concerning severity of illness, CPRs in ill PIs might reflect inadequate stress reaction. This could reveal persistence of intrauterine mechanisms of cortisol regulation. Supported by DFG grant (HE 3557/1–1) to M.H. and S.A.W.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Heckmann, M., Hartmann, M., Kampschulte, B. et al. 105 Cortisol Production Rates do not Increase During Critical Illness in Preterm Infants. Pediatr Res 56, 482 (2004). https://doi.org/10.1203/00006450-200409000-00128
Issue Date:
DOI: https://doi.org/10.1203/00006450-200409000-00128