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Prenatal and postnatal inflammation in relation to cortisol levels in preterm infants at 18 months corrected age

A Gover1, V Chau, S P Miller

  • 1Developmental Neurosciences and Child Health, Child and Family Research Institute, University of British Columbia, Vancouver, BC, Canada.

Journal of Perinatology : Official Journal of the California Perinatal Association
|April 6, 2013
PubMed

Insights

Prenatal inflammation, specifically chorioamnionitis with funisitis, altered cortisol patterns in very preterm infants by 18 months corrected age. This suggests early inflammatory stress may impact the hypothalamic-pituitary-adrenal axis development.

Area of Science:

  • Neonatal research
  • Pediatric endocrinology
  • Developmental pediatrics

Background:

  • The hypothalamic-pituitary-adrenal (HPA) axis regulates stress response.
  • Early life stress and inflammation can impact neurodevelopment.
  • Very preterm infants are vulnerable to inflammatory insults.

Purpose of the Study:

  • To investigate the relationship between early inflammation and cortisol levels at 18 months corrected age (CA) in very preterm infants.
  • To determine if prenatal inflammatory conditions affect HPA axis function in this population.

Main Methods:

  • Recruited infants born ≤ 32 weeks gestational age.
  • Collected placental histopathology, MRI, and chart data.
  • Assessed development and collected salivary cortisol samples at 18 months CA, analyzing data from 85 infants.

Main Results:

  • Chorioamnionitis with funisitis was associated with a significantly different cortisol pattern at 18 months CA.
  • Infants with chorioamnionitis alone or no prenatal inflammation showed distinct cortisol patterns.
  • Postnatal infections and common neonatal morbidities were not significantly linked to cortisol patterns.

Conclusions:

  • Prenatal inflammatory stress may alter the programming of the HPA axis in very preterm children.
  • Early inflammatory exposures could have long-term implications for stress regulation.
  • Findings highlight the importance of monitoring HPA axis function in vulnerable preterm populations.
Abstract

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