Related Experiment Video
Updated: Jul 10, 2026
A Modified Trier Social Stress Test for Vulnerable Mexican American Adolescents
Published on: July 10, 2017
Glucocorticoid exposure in preterm babies predicts saliva cortisol response to immunization at 4 months
Vivette Glover1, Rachel Miles, Simon Matta
1Wolfson and Weston Research Centre for Family Health, Institute of Reproductive and Developmental Biology, Imperial College London, UK. v.glover@imperial.ac.uk
Insights
Neonatal glucocorticoid exposure in preterm infants influences later stress responses. Early high cortisol levels predict the infant
Area of Science:
- Neonatal Medicine
- Endocrinology
- Developmental Pediatrics
Background:
- Preterm infants face significant neonatal stressors.
- Elevated endogenous and exogenous glucocorticoids may program the hypothalamic-pituitary-adrenal (HPA) axis.
- Long-term effects of early stress exposure on HPA axis function are a concern.
Purpose of the Study:
- To investigate if neonatal glucocorticoid exposure predicts HPA axis reactivity to immunization in preterm infants.
- To determine the relationship between endogenous and exogenous glucocorticoid levels and subsequent stress responses.
Main Methods:
- Longitudinal follow-up of 45 infants born before 32 weeks gestation.
- Measurement of plasma cortisol in the first 4 weeks of life.
- Assessment of saliva cortisol response to routine immunization at 4 and 12 months of age.
- Path analysis to identify contributing factors to cortisol response.
Main Results:
- Neonatal plasma cortisol levels were significantly higher than fetal levels.
- Mean circulating cortisol in the first 4 weeks predicted the saliva cortisol response to immunization at 4 months, but not at 12 months.
- Birthweight for gestational age, antenatal, and postnatal steroid therapy influenced the 4-month cortisol response.
Conclusions:
- The magnitude of glucocorticoid exposure in preterm neonates impacts HPA axis programming.
- Early life glucocorticoid exposure may affect the development of stress reactivity in preterm infants.
- Findings highlight the potential long-term consequences of neonatal stress and steroid administration.
Abstract:
Preterm babies are exposed to multiple stressors and this may have long-term effects. In particular, high levels of endogenous cortisol might have a programming effect on the hypothalamic-pituitary-adrenal axis as may administered glucocorticoids. In this study, we aimed to test the hypothesis that the level of endogenous and exogenous glucocorticoid exposure during the neonatal period predicts the saliva cortisol response to immunization at 4 mo of age. We followed 45 babies born below 32 wk gestation. We showed that their concentration of plasma cortisol during the first 4 wk was 358, 314, 231, and 195 nmol/L cortisol, respectively (geometric mean). This is four to seven times higher than fetal levels at the same gestational age range. We used routine immunization at 4 mo and 12 mo as a stressor and measured the change in saliva cortisol as the stress response. Mean circulating cortisol in the first 4 wk predicted the cortisol response at 4 but not at 12 mo. Path analysis showed that birthweight for gestational age, therapeutic antenatal steroids, and therapeutic postnatal steroids also contributed to the magnitude of the saliva cortisol response at 4 mo. This provides evidence that the magnitude of glucocorticoid exposure, both endogenous and exogenous, may have an effect on later stress responses.
More Related Videos
05:31Noninvasive Sampling of Mucosal Lining Fluid for the Quantification of In Vivo Upper Airway Immune-mediator Levels
Published on: August 7, 2017
06:39Using a Murine Model of Psychosocial Stress in Pregnancy as a Translationally Relevant Paradigm for Psychiatric Disorders in Mothers and Infants
Published on: June 13, 2021
Related Concept Videos
01:22Development of Immunocompetence
The initial cells that migrate from the fetal thymus settle within the skin and epithelial tissues lining the mouth, digestive tract, and in females, the uterus and vagina. These cells, including skin-based dendritic cells, serve as antigen-presenting cells, playing a key role in T cell activation.
Subsequent T...
01:28Development of the Oral Microbiota