Cortisol precursors in neonates with vasopressor-resistant hypotension in relationship to demographic characteristics
Khashana, Abdelmoneim; Ahmed, Hoda; Ahmed, Amal; Abdelwahab, Amina; Saarela, Timo; Rämet, Mika; Hallman, Mikko (2017-07-11)
Abdelmoneim Khashana, Hoda Ahmed, Amal Ahmed, Amina Abdelwahab, Timo Saarela, Mika Rämet & Mikko Hallman (2018) Cortisol precursors in neonates with vasopressor-resistant hypotension in relationship to demographic characteristics, The Journal of Maternal-Fetal & Neonatal Medicine, 31:18, 2473-2477, DOI: 10.1080/14767058.2017.1344966
This is an Accepted Manuscript of an article published by Taylor & Francis in the Journal of Maternal-Fetal and Neonatal Medicine on 11 Jul 2017, available online: https://doi.org/10.1080/14767058.2017.1344966
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2020090267176
Tiivistelmä
Abstract
Objective:To correlate between cortisol precursors in neonates with vasopressor resistant hypotension and demographic characteristics.
Methods:We investigated 48 neonates with vasopressor-resistant hypotension. Gestation at birth ranged from 34 to 42 weeks and postnatal age from 4 to 14 days. Cortisol and precursor steroids were measured soon after the onset of volume expansion and inotropes for treatment of shock. Their concentrations were determined using liquid chromatography/mass spectrometry.
Results:In neonates with vasopressor-resistant hypotension, the serum levels of cortisol were within normal nonstress range. There was a strong negative linear association between postnatal age and dehydroepiandrosterone level (r = −0.50, p < .01), which decreased with neonatal age. In addition, there was a significant positive association between gestational age at birth and 17-hydroxy-pregnenolone (r = 0.33, p = .02). No further significant associations were evident between the neonatal weight, duration of gestation or gender and of the levels of cortisol or the other steroids (p > .05). The cause of therapy-resistant hypotension did not appear to influence the steroid levels.
Conclusions:Cortisol stress response is absent in these severely ill late preterm and term infants. This may be due to inhibition of the distal pathway of cortisol synthesis.
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