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Limited response to CRH stimulation tests at two weeks of age in preterm infants born at less than 30 weeks of gestational age.
MedLine Citation:
PMID:  23009353     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: The high incidence of glucocorticoid-responsive complications in extremely preterm infants suggests the immaturity of their adrenal function; however, knowledge of the hypothalamus-pituitary-adrenal (HPA) axis in extremely preterm infants is limited. METHODS: In order to clarify the characteristics of the HPA axis in preterm very low birth weight (VLBW) infants, we performed CRH tests repeatedly: at about two weeks of age and at term (37-41 weeks of postmenstrual age) for 21 VLBW infants with a gestational age (GA) <30 weeks at birth. RESULTS: Basal cortisol values at two weeks of age were significantly higher than those at term in VLBW infants <30 weeks of gestation at birth (304.1 ± 146.3nmol/L vs. 184.7 ± 108.2 nmol/L). Response to CRH stimulation tests at two weeks of age was significantly lower than at term (delta cortisol 148.3 ± 90.7 nmol/L vs. 271.8 ± 167.0 nmol/L, delta ACTH 3.9 ± 3.2 pmol/L vs. 12.3 ± 9.2 pmol/L, respectively). We found that earlier GA contributed to the higher basal cortisol values, and antenatal glucocorticoid (AG) contributed to the lower response of cortisol to CRH tests at two weeks of age. CONCLUSIONS: VLBW infants showed a characteristic pattern in the HPA axis at two weeks of age; higher basal cortisol values and lower response to CRH tests. This study suggested that AG was related to the lower response to CRH tests, at least partly. © 2012 Blackwell Publishing Ltd.
Authors:
Fusako Niwa; Masahiko Kawai; Hoshinori Kanazawa; Kougorou Iwanaga; Takashi Matsukura; Minoru Shibata; Takeshi Hasegawa; Toshio Heike
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-25
Journal Detail:
Title:  Clinical endocrinology     Volume:  -     ISSN:  1365-2265     ISO Abbreviation:  Clin. Endocrinol. (Oxf)     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0346653     Medline TA:  Clin Endocrinol (Oxf)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Department of Pediatrics, Graduate School of Medicine, Kyoto University.
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