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Adrenal function in preterm infants

J H Honour1, K Wickramaratne, H B Valman

  • 1Cobbold Laboratory, Middlesex Hospital, London, UK.

Biology of the Neonate
|January 1, 1992
PubMed

Insights

Preterm infant adrenal function matures similarly to full-term infants after 28 weeks gestation. Infants under 28 weeks may retain fetal adrenal mechanisms longer, impacting steroid metabolism.

Area of Science:

  • Endocrinology
  • Neonatal Physiology
  • Pediatric Metabolism

Background:

  • The adrenal gland plays a crucial role in infant development and stress response.
  • Preterm infants exhibit unique physiological adaptations compared to term infants.
  • Understanding adrenal function in preterm neonates is vital for optimizing care.

Purpose of the Study:

  • To longitudinally assess adrenal function in preterm infants.
  • To compare the maturation of the fetal adrenal zone in preterm versus term infants.
  • To investigate potential mechanisms underlying prolonged fetal adrenal zone function in extremely preterm infants.

Main Methods:

  • Longitudinal assessment of adrenal function in 10 preterm infants (27-34 weeks gestation).
  • Measurement of steroid metabolite excretion rates in 24-hour urine samples.
  • Urine samples collected frequently for up to 80 days post-delivery.

Main Results:

  • Steroid excretion changes in preterm infants (>28 weeks gestation) mirrored involution seen in term infants.
  • This suggests removal of estrogen's inhibitory effect on 3 beta-hydroxysteroid dehydrogenase post-birth.
  • Infants <28 weeks gestation showed continued fetal adrenal zone function beyond one month.

Conclusions:

  • Adrenal function maturation in preterm infants over 28 weeks gestation is comparable to term infants.
  • Extremely preterm infants (<28 weeks gestation) may exhibit prolonged fetal adrenal zone activity.
  • This prolonged activity might be due to persistent, yet unidentified, fetal regulatory adrenal mechanisms.

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