University of Oulu

Khashana, A., Ahmed, E. (2017) Hyperdehydroepiandrosterone in neonates with hypoxic ischemic encephalopathy and circulatory collapse. Pediatrics and Neonatology, 58 (6), 504-508. doi:10.1016/j.pedneo.2016.09.010

Hyperdehydroepiandrosterone in neonates with hypoxic ischemic encephalopathy and circulatory collapse

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Author: Khashana, Abdelmoneim1,2; Ahmed, Engy3
Organizations: 1PEDEGO Research Center, Medical Research Center Oulu, University of Oulu
2Department of Pediatrics and Neonatology, Suez Canal University Hospital
3Epidemiology and Statistics, Health authority, Ismailia, Egypt
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Elsevier, 2017
Publish Date: 2018-02-09


Background: Circulatory collapse is a very common complication of the critical illnesses in neonates including neonates with hypoxic ischemic encephalopathy; it can be the end result and cause of death of several conditions. Often, despite treatment with fluid resuscitation and vasopressor agents, circulatory collapse persist, and blood pressure can remain critically low, compromising adequate blood flow to vital organs and brain. Low blood pressure has been associated with increased mortality.

Method: To investigate adrenal function in newborn infants who suffer from circulatory collapse during hypoxic ischemic encephalopathy. A total of 30 infants were analyzed in the study: 15 neonates in group A (neonates had hypoxic ischemic encephalopathy with vasopressor resistant hypotension) and 15 neonates in group B (neonates with hypoxic ischemic encephalopathy without vasopressor resistant hypotension). All the studied patients were subjected to history, examinations and laboratory investigation including serum cortisol concentrations and cortisol precursor’s levels.

Results: The cortisol concentrations did not differ significantly between the two groups: (12.9 ± 4.3) μg/dL and (12.1 ± 2.4) μg/dL in group A and group B, respectively. There are highly significant differences between groups A and B regarding Dehydroepiandrosterone (342.1 ± 101.3) μg/dL, (33.4 ± 16.5) μg/dL, respectively.

Conclusion: In this study, we noticed that cortisol concentrations did not differ between both groups in contrast to the expectation that neonates with critical illnesses should have higher cortisol concentrations than normal neonates. However, the marked increase in dehydroepiandrosterone DHEA may cause decrease cortisol function, so those neonates having accumulation of dehydroepiandrosterone may suffer from manifestation of adrenal insufficiency and vasopressor resistant hypotension in spite of normal cortisol level.

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Series: Pediatrics and neonatology
ISSN: 1875-9572
ISSN-E: 2212-1692
ISSN-L: 1875-9572
Volume: 58
Issue: 6
Pages: 504 - 508
DOI: 10.1016/j.pedneo.2016.09.010
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Copyright information: © 2017, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license.