Hormone Research in Paediatrics

Original Paper

Longitudinal Evaluation of Salivary Cortisol Levels in Full-Term and Preterm Neonates

Bettendorf M.a · Albers N.d · Bauer J.b · Heinrich U.E.a · Linderkamp O.b · Maser-Gluth C.c

Author affiliations

Department of Paediatrics,a Paediatric Endocrinology, and b Neonatology, c Department of Pharmacology, University of Heidelberg, and d Department of Paediatrics, Paediatric Endocrinology, University of Bonn, Germany

Keywords: Salivary cortisolNeonatesDexamethasoneBudesonide

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Horm Res 1998;50:303–308
https://doi.org/10.1159/000023295

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: February 12, 1999
Issue release date: December 1998

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 3

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: https://www.karger.com/HRP

Abstract

The aim of the present study was to test the practicability of sequential cortisol determinations in saliva of low birth weight neonates and to evaluate the impact of systemic and inhaled glucocorticoid therapy on saliva concentrations of cortisol in preterm neonates with bronchopulmonary dysplasia (BPD). Salivary cortisol levels were measured by RIA in saliva samples from 10 full-term and 10 preterm healthy neonates and from 20 preterm neonates with BPD during systemic [dexamethasone (DEX); n = 10] or topical steroid therapy [budesonide (BUD); n = 10]. Saliva samples of each individual were collected on 3 consecutive days at 06.00, 12.00, 18.00 and 24.00 h. Cortisol levels in saliva ranged from 0.8 to 60.6 nmol/l (median 6.5 nmol/l) in full-term neonates, from 0.6 to 52.1 nmol/l (median 5.5 nmol/l) in preterm neonates, from 0.4 to 14.0 nmol/l (median 1.0 nmol/l) in preterm neonates treated with DEX and from 0.4 to 15.2 nmol/l (median 2.5 nmol/l) in preterm neonates treated with BUD. Autocorrelation analysis revealed a distinct endogenous cortisol rhythm in 2 of the 10 healthy full-term neonates and in 3 of the 10 healthy preterm neonates with a wavelength of 12–30 h. Salivary cortisol levels in preterm neonates treated with DEX or BUD were significantly lower than those measured in healthy preterm neonates. These results demonstrate that the measurement of salivary cortisol levels is a reliable and practicable way of assessing adrenal function in full-term and preterm neonates. This study also shows for the first time that some neonates display an endogenous cortisol rhythm which is not coupled to the exogenous day/night cycle. Furthermore, systemic and nebulized glucocorticoids suppress adrenal function in low-birth-weight neonates. After treatment these children should be closely monitored for potential adrenal insufficiency.



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References

  1. Collaborative Group on Antenatal Steroid Therapy: Effect of antenatal dexamethasone administration on the prevention of respiratory distress syndrome. Am J Obstet Gynecol 1981;141:276–284.
    External Resources
  2. Avery GB, Fletcher AB, Kaplan M, Brudno DS: Controlled trial of dexamethasone in respirator-dependent infants with bronchopulmonary dysplasia. Pediatrics 1985;75:106–111.
    External Resources
  3. Collaborative Dexamethasone Trial Group: Dexamethasone therapy in neonatal chronic lung disease: An international placebo-controlled trial. Pediatrics 1991;88:421–427.
    External Resources
  4. Durand M, Sardesai S, McEvoy C: Effects of early dexamethasone therapy on pulmonary mechanics and chronic lung disease in very low birth weight infants: A randomized controlled trial. Pediatrics 1995;95:584–590.
    External Resources
  5. Kazzi NJ, Brans YW, Poland RL: Dexamethasone effects on the hospital course of infants with bronchopulmonary dysplasia who are dependent on artificial ventilation. Pediatrics 1990;86:722–727.
    External Resources
  6. Knoppert DC, Mackanjee HS: Current strategies in the management of bronchopulmonary dysplasia: the role of corticosteroids. Neonatal Network 1994;13:53–60.
  7. Wilson DM, Baldwin RB, Ariagno RL: A randomized, placebo-controlled trial of effects of dexamethasone on hypothalamic-pituitary-adrenal axis in preterm infants. J Pediatr 1988;113:764–768.
    External Resources
  8. LaForce WR, Brudno SS: Controlled trial of beclomethasone dipropionate by nebulization in oxygen- and ventilator-dependent infants. J Pediatr 1993;122:285–288.
    External Resources
  9. Saha M-T, Laippala P, Lenko HL: Growth of asthmatic children is slower during than before treatment with inhaled glucocorticoids. Acta Paediatr 1997;86:138–142.
    External Resources
  10. Broide J, Soferman R, Kivity S, Golander A, Dickstein G, Spirer Z, Weisman Y: Low-dose adrenocorticotropin test reveals impaired adrenal function in patients taking inhaled corticosteroids. J Clin Endocrinol Metab 1995;80:1243–1246.
    External Resources
  11. Volovitz B, Amir J, Malik H, Kauschansky A, Varsano I: Growth and pituitary-adrenal function in children with severe asthma treated with inhaled budesonide. N Engl J Med 1993;329:1703–1708.
    External Resources
  12. Helbock HJ, Insoft RM, Conte FA: Glucocorticoid-responsive hypotension in extremely low birth weight newborns. Pediatrics 1993;92:715–717.
    External Resources
  13. Korte C, Styne D, Merritt TA, Mayes D, Wertz A, Helbock HJ: Adrenal function in the very low birth weight infant: Improved testing sensitivity and association with neonatal outcome. J Pediatr 1996;128:257–263.
    External Resources
  14. Watterberg KL, Scott SM: Evidence of early adrenal insufficiency in babies who develop bronchopulmonary dysplasia. Pediatrics 1995;95:120–125.
    External Resources
  15. Santiago LB, Jorge SM, Moreira AC: Longitudinal evaluation of the development of salivary cortisol circadian rhythm in infancy. Clin Endocrinol 1996;44:157–161.
  16. Kari MA, Raivio KO, Stenman U-H, Voutilainen R: Serum cortisol, dehydroepiandrosterone sulfate, and steroid-binding globulins in preterm neonates: effect of gestational age and dexamethasone therapy. Pediatr Res 1996;40:319–324.
    External Resources
  17. Rizvi ZB, Aniol HS, Meyers TF, Zeller WP, Fisher SG, Anderson CL: Effects of dexamethasone on the hypothalamic-pituitary-adrenal axis in preterm infants. J Pediatr 1992;120:961–965.
    External Resources
  18. Kiess W, Meidert A, Dressendörfer RA, Schriever K, Kessler U, König A, Schwarz HP, Strasburger CJ: Salivary cortisol levels throughout childhood and adolescence: Relation with age, pubertal stage, and weight. Ped Res 1995;37:502–506.
    External Resources
  19. Laudat MH, Cerdas S, Fournier C, Guiban D, Guilhaume B, Luton JP: Salivary cortisol measurement: a practical approach to assess pituitary-adrenal function. J Clin Endocrinol Metab 1988;66:343–348.
    External Resources
  20. Francis SJ, Walker RF, Riad-Fahmy D, Hughes D, Murphy JF, Gray OP: Assessment of adrenocortical activity in term newborn infants using salivary cortisol determinations. J Pediatr 1987;111:129–133.
    External Resources
  21. Connolly TM, Vecsei P: Simple radioimmunoassay of cortisol in diluted samples of human plasma. Clin Chem 1978;9:1468–1472.
  22. Aderjan R, Rauh W, Vecsei P, Lorenz U, Ruttgers H: Determination of cortisol, tetrahydrocortisol, tetrahydrocortisone, corticosterone and aldosterone in human amniotic fluid. J Steroid Biochem 1977;8:525–528.
    External Resources
  23. Chatfield C: Estimation in the time domain; in Chatfield C (ed): The Analysis of Time Series. London, Chapman & Hall, 1996, pp 49–65.
  24. Onishi S, Miyazawa G, Nishimura Y, Sugiyama S, Yamakawa T, Inagaki H, Katoh T, Itoh S, Isobe K: Postnatal development of circadian rhythm in serum cortisol levels in children. Pediatrics 1983;72:399–404.
    External Resources
  25. Price DA, Close GC, Fielding BA: Age of appearance of circadian rhythm in salivary cortisol values in infancy. Arch Dis Child 1983;58:454–456.
    External Resources
  26. Hingre RV, Gross SJ, Hingre KS, Mayes MD, Richman RA: Adrenal steroidogenesis in very low birth weight preterm infants. J Clin Endocrinol Metab 1994;78:266–270.
    External Resources
  27. Lee MM, Rajagopalan L, Berg GJ, Moshang T: Serum adrenal steroid concentrations in premature infants. J Clin Endocrinol Metab 1989;69:1133–1136.
    External Resources
  28. Al Saedi S, Dean H, Dent W, Cronin C: Reference ranges for serum cortisol and 17-hydroxyprogesterone levels in preterm infants. J Pediatr 1995;126:985–987.
    External Resources
  29. Hanna CE, Keith LD, Calasurdo MA, Buffkin DC, Laird MR, Mandel SH, Cook DM, LaFranchi SH, Reynolds JW: Hypothalamic pituitary adrenal function in the extremely low birth weight infant. J Clin Endocrinol Metab 1993;76:384–387.
    External Resources
  30. Riad-Fahmy D, Read GF, Walker RF, Griffiths K: Steroids in saliva for assessing endocrine function. Endocr Rev 1982;3:367–395.
    External Resources
  31. Rokicki W, Forest MG, Loras B, Bonnet H, Bertrand J: Free cortisol of human plasma in the first three months of life. Biol Neonate 1990;57:21–29.
    External Resources
  32. Johnson M: Pharmacodynamics and pharmacokinetics of inhaled glucocorticoids. J Allergy Clin Immunol 1996;97:169–176.
    External Resources

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Published online: February 12, 1999
Issue release date: December 1998

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 3

ISSN: 1663-2818 (Print)
eISSN: 1663-2826 (Online)

For additional information: https://www.karger.com/HRP

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1998, Vol.50, No. 6

December 1998

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