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A Preliminary Study of Correlates of Premature Birth and Their Influence on Cortisol Levels in Young Children

Sophia Kloosterboer1, Fabiënne Bertina Anolda Naber2, Hiltje Heyman3

  • 1Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands.

Biological Research for Nursing
|October 20, 2023
PubMed

Insights

Cesarean delivery is linked to lower cortisol levels in children born prematurely. This finding suggests potential Hypothalamic-Pituitary-Adrenal (HPA) axis alterations, which may impact later development in these children.

Area of Science:

  • Pediatric endocrinology
  • Neuroscience
  • Developmental biology

Background:

  • The Hypothalamic-Pituitary-Adrenal (HPA) axis programming in early infancy is crucial for stress response.
  • Limited understanding exists regarding HPA axis programming in premature or small for gestational age (SGA) infants.

Purpose of the Study:

  • To investigate the influence of prematurity and birth-related factors on cortisol levels in young children.
  • To explore the relationship between birth delivery route and HPA axis activity in premature infants.

Main Methods:

  • A cross-sectional study involving 38 participants born prematurely (<37 weeks gestation), aged 3-9 years.
  • Cortisol levels were measured and analyzed using regression analysis to assess correlates of prematurity, including delivery route.

Main Results:

  • Cesarean delivery was significantly associated with lower cortisol levels in prematurely born children (ß = -0.42, p = 0.028).
  • Delivery route explained 34% of the variance in cortisol levels, after correcting for sex.

Conclusions:

  • Cesarean birth is linked to reduced cortisol levels in prematurely born children, indicating potential HPA axis alterations.
  • These findings highlight the clinical relevance of birth delivery route on HPA axis development and may have implications for future developmental outcomes.
  • Further research is needed to explore indications for C-sections and their specific impact on HPA axis programming in this population.
Abstract

Keywords:
cortisoldelivery routehypothalamic-pituitary-adrenal-axisprematuritypreterm children

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