Association of Plasma Cortisol Levels with Gestational Age and Anthropometric Values at Birth in Preterm Infants
Abstract
:1. Introduction
2. Materials and Methods
2.1. Eligible Infants
2.2. Blood Sample Collection and Plasma Cortisol Measurement
2.3. Nutrition Policy from Birth to One-Month of Age
2.4. Clinical Characteristics and Disease Definitions
2.5. Statistical Analysis
3. Results
3.1. Study 1
3.1.1. Clinical Characteristics
3.1.2. Plasma Cortisol Levels at Birth and at 1 Month of Age
3.1.3. Association between Plasma Cortisol Levels and GA, and Anthropometric Values at Birth
3.2. Study 2
3.2.1. Clinical Characteristics
3.2.2. Plasma Cortisol Levels
4. Discussion
4.1. Maternal Steroid Administration and Fetal Cortisol Levels
4.2. Factors Affecting Plasma Cortisol Levels and Physique
4.3. Plasma Cortisol Levels in Preterm SGA Infants
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Mothers | N = 53 |
Age at delivery, years | 31 (24–36) |
Pre-pregnancy BMI, kg/m2 | 21.5 (15.6–33.8) |
Weight gain during pregnancy, kg | 5.9 (0.0–24.4) |
Height, cm | 156.9 (144.6–172.0) |
Placenta weight, g | 348 (136–804) |
Di- and tri-chorionic births, n (%) | 6 (11.3) |
Hypertensive disorders of pregnancy, n (%) | 16 (30.2) |
Gestational diabetes mellitus, n (%) | 1 (1.9) |
Chorioamnionitis, n (%) | 28 (52.8) |
Prepartum use of betamethasone, n (%) | 37 (69.8) |
Last use of betamethasone, days before delivery, n = 37 | 6 (0–35) |
Infants | N = 61 |
Male sex, n (%) | 22 (36) |
GA, weeks | 31 (24–36) |
BW, g | 1424 (464–2834) |
BW SDS | −0.91(−4.23–1.69) |
BL, cm | 39.0 (28.0–47.0) |
BL SDS | −0.9 (−4.23–1.69) |
Birth head circumstance, cm | 28.8 (20.0–34.5) |
Birth head circumstance SDS | −0.16 (−2.48–1.92) |
Respiratory distress syndrome, n (%) | 26 (42.6) |
Chronic lung disease, n (%) | 14 (23.0) |
Late-onset circulatory collapse, n (%) | 5 (8.2) |
Patent ductus arteriosus, n (%) | 0 (0) |
Sepsis, n (%) | 1 (1.6) |
Retinopathy of prematurity, n (%) | 2 (3.3) |
Necrotizing enterocolitis, n (%) | 0 (0) |
Meconium disease, n (%) | 2 (3.3) |
Intraventricular hemorrhage, n (%) | 0 (0) |
Periventricular leukomalacia, n (%) | 2 (3.3) |
A. Cortisol Level at Birth | ||
Coefficient of Determination | p-Value | |
GA, weeks | 0.154 | 0.002 |
BW SDS | 0.057 | 0.063 |
BL SDS | 0.063 | 0.051 |
Birth head circumference SDS | 0.015 | 0.344 |
B. Cortisol Level at 1 Month of Age | ||
Coefficient of Determination | p-Value | |
GA, weeks | 0.146 | 0.002 |
BW SDS | 0.014 | 0.370 |
BL SDS | 0.010 | 0.453 |
Birth head circumference SDS | 0.058 | 0.062 |
C. Δ Cortisol | ||
Coefficient of Determination | p-Value | |
GA, weeks | 0.067 | 0.044 |
BW SDS | 0.037 | 0.137 |
BL SDS | 0.031 | 0.172 |
Birth head circumference SDS | 0.078 | 0.029 |
A. Cortisol Level at Birth | ||
Partial Correlation Coefficient (95% CI) | p-Value | |
GA, weeks | 0.191 (0.092–0.290) | <0.001 |
BW SDS | −0.459 (−0.934–0.015) | 0.058 |
BL SDS | −0.127 (−0.581–0.328) | 0.580 |
Birth head circumference SDS | 0.495 (−0.125–1.114) | 0.115 |
B. Cortisol Level at 1 Month of Age | ||
Partial Correlation Coefficient (95% CI) | p-Value | |
GA, weeks | 0.558 (0.236–0.881) | 0.001 |
BW SDS | −1.151 (−2.700–0.398) | 0.142 |
BL SDS | 0.095 (−1.389–1.578) | 0.899 |
Birth head circumference SDS | 2.533 (0.514–4.552) | 0.015 |
C. Δ Cortisol | ||
Partial Correlation Coefficient (95% CI) | p-Value | |
GA, weeks | 0.367 (0.028–0.707) | 0.034 |
BW SDS | −0.692 (−2.323–0.939) | 0.399 |
BL SDS | 0.221 (−1.341–1.783) | 0.778 |
Birth head circumference SDS | 2.039 (−0.876–4.165) | 0.060 |
Mothers N = 53 | SGA N = 23 | Non-SGA N = 30 | p-Value |
Age at delivery, years | 31 (26–36) | 32 (24–36) | 0.212 |
Pre-pregnancy BMI, kg/m2 | 22.2 (16.7–33.8) | 20.9 (15.6–26.6) | 0.049 |
Weight gain during pregnancy, kg | 7.1 (1.0–24.4) | 5.8 (0.0–14.8) | 0.543 |
Height, cm | 157.6 (149.0–172.0) | 156.2 (144.6–168.0) | 0.287 |
Placenta weight, g | 311 (136–480) | 420 (242–804) | <0.001 |
Di- and tri-chorionic births, n (%) | 3 (13.0) | 3 (10.0) | 1.000 |
Hypertensive disorders of pregnancy, n (%) | 12 (52.2) | 4 (13.3) | 0.006 |
Gestational diabetes mellitus, n (%) | 1 (4.3) | 0 (0.0) | 0.434 |
Chorioamnionitis, n (%) | 10 (43.5) | 18 (60.0) | 0.276 |
Prepartum use of betamethasone, n (%) | 16 (69.6) | 21 (70.0) | 1.000 |
Last use of betamethasone, days before delivery, n = 37 | 14 (0–35), n = 16 | 4 (0–28), n = 21 | 0.113 |
Infants N = 61 | SGA N = 24 | Non-SGA N = 37 | |
Male sex, n (%) | 11 (45.8) | 11 (29.7) | 0.068 |
GA, weeks | 31 (26–36) | 32 (24–36) | 0.796 |
BW, g | 1051 (464–1900) | 1575 (578–2834) | <0.001 |
BW SDS | −2.5 (–4.23–−1.29) | −0.23 (−1.27–1.69) | <0.001 |
BL, cm | 36.4 (28.0–46.5) | 40.5 (30.0–47.0) | 0.001 |
BL SDS | −2.2 (−4.17–0.33) | −0.31 (−1.89–1.71) | <0.001 |
Birth head circumstance, cm | 26.7 (20.7–31.0) | 29.2 (20.0–34.5) | 0.013 |
Birth head circumstance SDS | −1.0 (−2.48–0.50) | 0.14 (−1.07–1.92) | <0.001 |
Respiratory distress syndrome, n (%) | 11 (45.8) | 15 (40.5) | 0.793 |
Chronic lung disease, n (%) | 7 (29.2) | 7 (18.9) | 0.370 |
Late-onset circulatory collapse, n (%) | 3 (12.5) | 2 (5.4) | 0.373 |
Sepsis, n (%) | 0 (0) | 1 (2.7) | 1.000 |
Retinopathy of prematurity, n (%) | 1 (4.2) | 1 (2.7) | 1.000 |
Meconium disease, n (%) | 1 (4.2) | 1 (2.7) | 1.000 |
Periventricular leukomalacia, n (%) | 1 (4.2) | 1 (2.7) | 1.000 |
All Infants N = 61 | SGA N = 24 | Non-SGA N = 37 | p-Value | |
---|---|---|---|---|
At birth, μg/dL | 2.02 (0.17–5.80) | 2.45 (0.51–5.80) | 1.62 (0.17–4.89) | 0.010 |
1 month of age, μg/dL | 5.80 (0.74–20.3) | 5.37 (0.74–13.7) | 5.80 (1.03–20.3) | 0.816 |
Δ cortisol, μg/dL | 4.21 (−4.91–19.39) | 2.28 (−4.91–11.47) | 4.61 (−2.55–19.39) | 0.181 |
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Aoki, M.; Urakami, T.; Nagano, N.; Aoki, R.; Morioka, I. Association of Plasma Cortisol Levels with Gestational Age and Anthropometric Values at Birth in Preterm Infants. Int. J. Environ. Res. Public Health 2022, 19, 11448. https://doi.org/10.3390/ijerph191811448
Aoki M, Urakami T, Nagano N, Aoki R, Morioka I. Association of Plasma Cortisol Levels with Gestational Age and Anthropometric Values at Birth in Preterm Infants. International Journal of Environmental Research and Public Health. 2022; 19(18):11448. https://doi.org/10.3390/ijerph191811448
Chicago/Turabian StyleAoki, Masako, Tatsuhiko Urakami, Nobuhiko Nagano, Ryoji Aoki, and Ichiro Morioka. 2022. "Association of Plasma Cortisol Levels with Gestational Age and Anthropometric Values at Birth in Preterm Infants" International Journal of Environmental Research and Public Health 19, no. 18: 11448. https://doi.org/10.3390/ijerph191811448