University of Oulu

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

Cortisol precursors in neonates with vasopressor-resistant hypotension in relationship to demographic characteristics

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Author: Khashana, Abdelmoneim1,2,3; Ahmed, Hoda3; Ahmed, Amal4;
Organizations: 1Medical Research Center Oulu, PEDEGO Research Unit, University of Oulu, Oulu, Finland
2Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
3Department of Pediatrics and Neonatology, Suez Canal University Hospital, Ismailia, Egypt
4Department of Clinical Pathology, Suez Canal University Hospital, Ismailia, Egypt
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link:
Language: English
Published: Informa, 2018
Publish Date: 2020-09-02


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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Series: Journal of maternal-fetal & neonatal medicine
ISSN: 1476-7058
ISSN-E: 1476-4954
ISSN-L: 1476-7058
Volume: 31
Issue: 18
Pages: 2473 - 2477
DOI: 10.1080/14767058.2017.1344966
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Copyright information: 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: