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Fetal and neonatal cortical adrenal function in birth asphyxia
R S Procianoy1, C B Giacomini, M L Oliveira
1Department of Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Acta Paediatrica Scandinavica
|September 1, 1988
Summary
Birth asphyxia in newborns is linked to higher cord serum cortisol and lower dehydroepiandrosterone sulfate levels. These differences normalize within 18 hours after birth, suggesting transient stress impacts.
Area of Science:
- Neonatal endocrinology
- Perinatal medicine
- Pediatric research
Background:
- Birth asphyxia is a critical condition in newborns.
- Hormonal responses in neonates under stress require further investigation.
- Cortisol and dehydroepiandrosterone sulfate are key adrenal hormones.
Purpose of the Study:
- To compare cord blood and early postnatal serum levels of cortisol and dehydroepiandrosterone sulfate in asphyxiated newborns versus controls.
- To investigate the transient nature of hormonal changes following birth asphyxia.
Main Methods:
- Comparative study of 18 asphyxiated and 23 normal newborns (gestational age 36-42 weeks).
- Measurement of serum cortisol and dehydroepiandrosterone sulfate in cord blood and 12-18 hours post-birth.
- Control for confounding factors like gestational age, birthweight, and maternal pre-eclampsia.
Main Results:
- Asphyxiated newborns showed significantly higher cord serum cortisol levels.
- Asphyxiated newborns exhibited significantly lower cord serum dehydroepiandrosterone sulfate levels.
- Hormone levels in both groups were similar 12-18 hours after birth.
Conclusions:
- Elevated cord cortisol in asphyxiated neonates may indicate adrenal definitive zone stimulation due to stress.
- Reduced cord dehydroepiandrosterone sulfate suggests a hypoxemic-ischemic impact on the adrenal fetal zone.
- Hormonal changes are transient, normalizing within hours post-birth.