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Normative salivary cortisol values and responsivity in children

Ann Marie McCarthy1, Kirsten Hanrahan, Charmaine Kleiber

  • 1College of Nursing, University of Iowa, Iowa City, IA 52242, USA. ann-mccarthy@uiowa.edu

Applied Nursing Research : ANR
|January 28, 2009
PubMed

Insights

This study found that salivary cortisol levels in children increase significantly during stressful medical procedures like IV placement. Salivary cortisol effectively measures children's stress response to medical interventions.

Area of Science:

  • Pediatric endocrinology
  • Child psychology
  • Medical stress response

Background:

  • Understanding children's physiological stress responses is crucial for effective healthcare.
  • Salivary cortisol is a non-invasive biomarker for assessing stress in pediatric populations.
  • Previous research has explored parental coaching and distraction techniques during pediatric procedures.

Purpose of the Study:

  • To establish normative salivary cortisol values in children aged 4-10 years.
  • To assess salivary cortisol responsivity to a hospital clinic visit and intravenous (IV) procedure.
  • To evaluate salivary cortisol as a measure of stress and intervention effectiveness.

Main Methods:

  • Descriptive study involving 384 children aged 4-10 years.
  • Salivary cortisol samples collected at baseline (home), upon clinic arrival, and post-IV insertion.
  • Normative values established using baseline data (8 a.m. - 3 p.m., non-procedural day).
  • Control group used to evaluate responsivity to the procedure.

Main Results:

  • Normative salivary cortisol levels in children exhibit a circadian pattern, decreasing from morning to afternoon.
  • Cortisol levels were significantly higher on the clinic day compared to baseline.
  • Salivary cortisol levels further increased in response to IV placement (15.7% +/- 6.7%, p = .023).
  • A significant Location x Time interaction (p = .019) was observed.

Conclusions:

  • Salivary cortisol is a reliable indicator of physiological stress in children during medical procedures.
  • The findings support the use of salivary cortisol to measure stress responses and evaluate intervention effectiveness in pediatric healthcare.
  • This research contributes to understanding children's stress physiology in clinical settings.

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