Adrenal function links to early postnatal growth and blood pressure at age 6 in children born extremely preterm

Area of Science:

• Endocrinology
• Pediatrics
• Neonatology

Background:

• Low birth weight is linked to adverse cardiometabolic outcomes, potentially due to excess glucocorticoid exposure.
• This study investigates the relationship between cortisol, adrenal androgens, birth weight, and cardiometabolic risk in preterm-born children.

Purpose of the Study:

• To determine if cortisol and dehydroepiandrosterone (DHEA) correlate inversely with birth weight and directly with cardiometabolic risk markers in school-aged children born extremely preterm.
• To compare cortisol and DHEA levels in preterm-born versus term-born children.

Main Methods:

• Saliva samples were collected at age 6 from 219 preterm-born and 40 term-born children.
• Dehydroepiandrosterone (DHEA) and cortisol levels were analyzed. Cortisol was also measured at home at awakening, 30 minutes later, and in the evening.

Main Results:

• In preterm-born children, cortisol and DHEA inversely correlated with weight and length Z-scores and positively with systolic blood pressure.
• Dehydroepiandrosterone (DHEA) was higher in preterm-born children compared to term-born children.
• Preterm-born children exhibited a blunted morning cortisol response compared to term-born children.

Conclusions:

• Cortisol and DHEA correlate with early postnatal growth and systolic blood pressure in extremely preterm-born children, suggesting perinatal programming.
• Blunted morning cortisol in preterm-born children may indicate stress from neonatal intensive care unit (NICU) exposure, similar to other adverse childhood experiences (ACEs).