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Serum adrenal steroid concentrations in premature infants
M M Lee1, L Rajagopalan, G J Berg
1Division of Endocrinology/Diabetes and Neonatology Children's Hospital, Philadelphia, Pennsylvania 19104.
Insights
Preterm infants show immature adrenal function, with higher steroid precursors and lower cortisol in sick infants, indicating potential stress-related adrenal reserve issues.
Area of Science:
- Endocrinology
- Neonatal Medicine
- Pediatric Biochemistry
Background:
- Preterm infants exhibit unique physiological adaptations.
- Adrenal steroidogenesis plays a critical role in neonatal health and stress response.
- Understanding adrenal function in preterm infants is crucial for clinical management.
Purpose of the Study:
- To assess serum adrenal steroid profiles in preterm infants.
- To compare these profiles between sick and healthy preterm infants.
- To compare preterm infant steroid levels with those of healthy full-term infants.
Main Methods:
- Serum concentrations of 17-hydroxyprogesterone (17-OHP), 17-hydroxypregnenolone, 11-deoxycortisol, cortisol, dehydroepiandrosterone (DHEA), DHEA sulfate, androstenedione, 18-hydroxycorticosterone, and aldosterone were measured.
- Measurements were performed in 9 sick and 13 healthy preterm infants.
- Data were compared to established values from healthy full-term infants.
Main Results:
- Sick preterm infants had higher 17-OHP, 11-deoxycortisol, and aldosterone than healthy preterm infants.
- Premature infants showed elevated 17-hydroxypregnenolone, 17-OHP, and DHEA sulfate compared to full-term infants.
- Cortisol and aldosterone levels were similar between preterm and full-term infants.
Conclusions:
- Elevated steroid precursors in preterm infants suggest relative adrenal enzyme immaturity.
- Lower cortisol levels in stressed sick preterm infants may indicate inadequate adrenal reserve for stress.
- These findings highlight potential adrenal functional deficits in preterm neonates.
Abstract:
To evaluate serum adrenal steroid concentrations in preterm infants, 17-hydroxyprogesterone (17-OHP), 17-hydroxypregnenolone, 11-deoxycortisol, cortisol, dehydroepiandrosterone (DHEA), DHEA sulfate, androstenedione, 18-hydroxycorticosterone, and aldosterone values were determined in 9 sick and 13 healthy premature infants. Serum steroid concentrations were compared to previously reported data from healthy full-term infants. 17-OHP, 11-deoxycortisol, and aldosterone values were higher in sick preterm infants than in healthy preterm infants. Compared to healthy full-term infants, the premature infants-had significantly higher 17-hydroxypregnenolone, 17-OHP, and DHEA sulfate concentrations. Cortisol values were not different between the sick and healthy preterm infants and were similar to full-term values. Aldosterone values were also similar between the premature and the full-term infants. The findings of elevated steroid precursors in preterm infants and low cortisol levels in stressed sick preterm infants may indicate a relative immaturity of adrenal enzyme activity and inadequate adrenal reserve for stress.