Skip to main content
Archives of Disease in Childhood logoLink to Archives of Disease in Childhood
. 1987 Oct;62(10):1014–1018. doi: 10.1136/adc.62.10.1014

Blood spot glucocorticoid concentrations in ill preterm infants.

D Hughes 1, J F Murphy 1, J Dyas 1, J A Robinson 1, D Riad-Fahmy 1, I A Hughes 1
PMCID: PMC1778662  PMID: 3674921

Abstract

The adrenocortical response to stress was studied longitudinally in 10 ill preterm infants using measurements of cortisol and 170H-progesterone concentrations in filter paper blood spots. Mean cortisol and 170H-progesterone concentrations reached a peak of 2200 nmol/l and 65 nmol/l, respectively, between the third and fifth days of life. These concentrations far exceeded those observed in older children and adults subjected to stress as a result of surgery. Further pulses of endogenous cortisol production of 4000 nmol/l or more occurred in association with clinical complications such as intraventricular haemorrhage. These results indicate that infants undergoing intensive care are unduly stressed. Consideration should be given to providing enough sedation and appropriate analgesia for ill preterm infants during painful procedures such as insertion of venous cannulae and arterial puncture.

Full text

PDF
1014

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Corbier P., Roffi J. Pituitary adrenocortical response to stress during the first day of post-natal life in the rat. Biol Neonate. 1978;34(3-4):105–111. doi: 10.1159/000241113. [DOI] [PubMed] [Google Scholar]
  2. Diez J. A., Sze P. Y., Ginsburg B. E. Postnatal development of mouse plasma and brain corticosterone levels: new findings contingent upon the use of a competitive protein-binding assay. Endocrinology. 1976 Jun;98(6):1434–1442. doi: 10.1210/endo-98-6-1434. [DOI] [PubMed] [Google Scholar]
  3. Forest M. G. Age-related response of plasma testosterone, delta 4-androstenedione, and cortisol to adrenocorticotropin in infants, children, and adults. J Clin Endocrinol Metab. 1978 Nov;47(5):931–937. doi: 10.1210/jcem-47-5-931. [DOI] [PubMed] [Google Scholar]
  4. Gutai J., George R., Koeff S., Bacon G. E. Adrenal response to physical stress and the effect of adrenocorticotropic hormone in newborn infants. J Pediatr. 1972 Oct;81(4):719–725. doi: 10.1016/s0022-3476(72)80092-1. [DOI] [PubMed] [Google Scholar]
  5. Kraiem Z., Kahana L., Elias V., Ghersin S., Sheinfeld M. Radioimmunoassay of cortisol in blood collected on filter paper. Clin Chem. 1980 Dec;26(13):1916–1917. [PubMed] [Google Scholar]
  6. Kraiem Z., Sack J., Brish M. Serum cortisol levels: the first 10 days in full-term and preterm infants. Isr J Med Sci. 1985 Feb;21(2):170–172. [PubMed] [Google Scholar]
  7. Murphy J. F., Joyce B. G., Dyas J., Hughes I. A. Plasma 17-hydroxyprogesterone concentrations in ill newborn infants. Arch Dis Child. 1983 Jul;58(7):532–534. doi: 10.1136/adc.58.7.532. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Plumpton F. S., Besser G. M., Cole P. V. Corticosteroid treatment and surgery. 1. An investigation of the indications for steroid cover. Anaesthesia. 1969 Jan;24(1):3–11. doi: 10.1111/j.1365-2044.1969.tb02798.x. [DOI] [PubMed] [Google Scholar]
  9. Reynolds J. W. Serum total corticoid and cortisol levels in premature infants with respiratory distress syndrome. Pediatrics. 1973 May;51(5):884–890. [PubMed] [Google Scholar]
  10. Riordan F. A., Wood P. J., Wakelin K., Betts P., Clayton B. E. Bloodspot 17 alpha-hydroxyprogesterone radioimmunoassay for diagnosis of congenital adrenal hyperplasia and home monitoring of corticosteroid replacement therapy. Lancet. 1984 Mar 31;1(8379):708–711. doi: 10.1016/s0140-6736(84)92223-2. [DOI] [PubMed] [Google Scholar]
  11. Robinson J. A., Dyas J., Hughes I. A., Riad-Fahmy D. Radioimmunoassay of blood-spot 17 alpha-hydroxyprogesterone in the management of congenital adrenal hyperplasia. Ann Clin Biochem. 1987 Jan;24(Pt 1):58–65. doi: 10.1177/000456328702400109. [DOI] [PubMed] [Google Scholar]
  12. SCHAPIRO S., GELLER E., EIDUSON S. Neonatal adrenal cortical response to stress and vasopressin. Proc Soc Exp Biol Med. 1962 Apr;109:937–941. doi: 10.3181/00379727-109-27384. [DOI] [PubMed] [Google Scholar]
  13. Stevens J. F. Plasma cortisol levels in the neonatal period. Arch Dis Child. 1970 Aug;45(242):592–594. doi: 10.1136/adc.45.242.592. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Thomas S., Murphy J. F., Dyas J., Ryalls M., Hughes I. A. Response to ACTH in the newborn. Arch Dis Child. 1986 Jan;61(1):57–60. doi: 10.1136/adc.61.1.57. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood are provided here courtesy of BMJ Publishing Group

RESOURCES