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A Prospective Longitudinal Study to Estimate the 'Adjusted Cortisol Percentile' in Preterm Infants.
MedLine Citation:
PMID:  21364494     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The normal range of serum cortisol concentrations and the appropriate levels of circulating cortisol in different clinical situations in preterm infants are not well defined. This study aimed to evaluate the impact of perinatal factors on circulating cortisol levels in preterm infants, and to create a quantitative model that could estimate the 'adjusted cortisol percentile'. Serial serum cortisol concentrations were measured in 209 infants ≤32 weeks gestation on days 1, 4, 7, 14 and 21 of life. Seven perinatal factors or conditions which could affect circulating cortisol level were identified. Serum cortisol levels were higher on day 4 (P=0.007) and 7 (P=0.007), but lower on day 21 (P=0.001) compared with day 1. Serum cortisol was also higher in infants:on nasal continuous positive airway pressure (P=0.003); requiring a second vasopressor (P<0.001); with intraventricular hemorrhage (≥Grade 3; P<0.001); histologic chorioamnionitis (P=0.007); severe lung disease (P=0.046), and; with decreasing gestational age (P<0.001). A mathematical equation was proposed based on factors derived in this preliminary study for estimating the adjusted cortisol percentile. Frontline neonatologists could now access the equation on our website <http://www.sta.cuhk.edu.hk/pswong/ACortP.html> to calculate the adjusted cortisol percentile, which could potentially improve the interpretation of circulating cortisol in different clinical situations. ABBREVIATIONS:
Authors:
Pak C Ng; Sam P S Wong; Iris H S Chan; Hugh S Lam; Cheuk H Lee; Christoper W K Lam
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-28
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Pediatrics [P.C.N., H.S.L., C.H.L.], Statistics [S.P.S.W.],Chemical Pathology [I.H.S.C., C.W.K.L.], Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong.
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