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Diurnal Cortisol Patterns and Dexamethasone Suppression Test Responses in Healthy Young Adults Born Preterm at Very
Nina Kaseva1, Riikka Pyhälä2,3, Anu-Katriina Pesonen2
1Chronic Disease Prevention Unit, Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
Insights
Preterm birth did not affect diurnal cortisol patterns or the stress response in young adults. This study found no long-term differences in hypothalamic-pituitary-adrenal axis function between those born very preterm and those born at term.
Area of Science:
- Endocrinology
- Developmental Psychology
- Neonatal Research
Background:
- Early life stress from neonatal intensive care can alter hypothalamic-pituitary-adrenal axis (HPAA) programming.
- Previous research suggests preterm infants may have a reduced HPAA stress response in adulthood.
- This study investigated HPAA function in unimpaired young adults born very low birth weight (VLBW).
Purpose of the Study:
- To assess diurnal salivary cortisol patterns in young adults born VLBW compared to term-born controls.
- To evaluate HPAA reactivity to a low-dose dexamethasone suppression test (DST) in these groups.
- To determine if preterm birth is associated with altered HPAA functioning in young adulthood.
Main Methods:
- Participants included 49 VLBW adults and 36 term-born controls (mean age 23.3 years).
- Saliva samples were collected on two days to measure diurnal cortisol levels.
- A low-dose DST was administered to assess HPAA suppression.
Main Results:
- No significant differences were found in overall diurnal salivary cortisol levels between VLBW and control groups.
- Cortisol awakening response was similar in both groups.
- Reactivity to the low-dose DST was also comparable between VLBW and control participants.
Conclusions:
- Diurnal cortisol patterns in young adulthood are not associated with very low birth weight or preterm birth.
- Reactivity to a low-dose dexamethasone suppression test does not differ between young adults born preterm and those born at term.
- Preterm birth, in unimpaired young adults, does not appear to alter everyday HPAA functioning or stress responsiveness.
Background:
Early life stress, such as painful and stressful procedures during neonatal intensive care after preterm birth, can permanently affect physiological, hormonal and neurobiological systems. This may contribute to altered programming of the hypothalamic-pituitary-adrenal axis (HPAA) and provoke changes in HPAA function with long-term health impacts. Previous studies suggest a lower HPAA response to stress in young adults born preterm compared with controls born at term. We assessed whether these differences in HPAA stress responsiveness are reflected in everyday life HPAA functioning, i.e. in diurnal salivary cortisol patterns, and reactivity to a low-dose dexamethasone suppression test (DST), in unimpaired young adults born preterm at very low birth weight (VLBW; <1500 g).
Methods:
The participants were recruited from the Helsinki Study of Very Low Birth Weight Adults cohort study. At mean age 23.3 years (2.1 SD), 49 VLBW and 36 controls born at term participated in the study. For cortisol analyzes, saliva samples were collected on two consecutive days at 0, 15, 30 and 60 min after wake-up, at 12:00 h, 17:00 h and 22:00 h. After the last salivary sample of the first study day the participants were instructed to take a 0.5 mg dexamethasone tablet.
Results:
With mixed-effects model no difference was seen in overall diurnal salivary cortisol between VLBW and control groups [13.9% (95% CI: -11.6, 47.0), P = 0.31]. Salivary cortisol increased similarly after awakening in both VLBW and control participants [mean difference -2.9% (29.2, 33.0), P = 0.85]. Also reactivity to the low-dose DST (awakening cortisol ratio day2/day1) was similar between VLBW and control groups [-1.1% (-53.5, 103.8), P = 0.97)].
Conclusions:
Diurnal cortisol patterns and reactivity to a low-dose DST in young adulthood were not associated with preterm birth.
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