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Related Experiment Videos

Response to ACTH in the newborn.

S Thomas, J F Murphy, J Dyas

    Archives of Disease in Childhood
    |January 1, 1986
    PubMed
    Summary

    Newborn infants, especially preterm and ill ones, show altered adrenal steroid levels. Adrenocorticotrophic hormone (ACTH) stimulation reveals appropriate adrenal responses, even in stressed infants with low cortisol.

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    Area of Science:

    • Neonatal endocrinology
    • Pediatric endocrinology
    • Adrenocortical physiology

    Background:

    • Adrenocortical function is critical in newborns, particularly in preterm and ill infants.
    • Maternal glucocorticoid use during pregnancy can influence fetal adrenal development.
    • Understanding basal and stimulated steroidogenesis is essential for neonatal care.

    Purpose of the Study:

    • To assess basal and adrenocorticotrophic hormone (ACTH)-stimulated adrenocortical function in different newborn groups.
    • To establish reference data for adrenal steroid levels in infants, considering maternal glucocorticoid exposure.
    • To investigate adrenal response in highly stressed newborns with initially undetectable cortisol.

    Main Methods:

    • Studied 52 newborn infants categorized into preterm well, preterm ill, and term ill groups.
    • Measured basal plasma 17-hydroxyprogesterone and cortisol concentrations.
    • Administered intramuscular ACTH (36 mcg/kg) and measured steroid responses.

    Main Results:

    • Significantly increased basal 17-hydroxyprogesterone in preterm infants (well and ill).
    • No significant difference in basal cortisol, but highest in preterm ill infants.
    • All infants showed a 2-3 fold increase in steroids post-ACTH stimulation; preterm ill infants had a higher peak 17-hydroxyprogesterone response.
    • Stressed infants with undetectable basal cortisol responded appropriately to ACTH.

    Conclusions:

    • Provides reference data for assessing infant adrenal function, especially with maternal glucocorticoid exposure.
    • Highlights a shift in fetal adrenal steroidogenesis post-birth, influenced by exogenous ACTH.
    • Suggests potential need for temporary glucocorticoid replacement in ~10% of stressed newborns with basal cortisol deficiency.

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