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Preterm EEG: A Multimodal Neurophysiological Protocol
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The cortisol awakening response in very preterm born adults compared to term born adults

Bilge Albayrak1, Giorgi Batsikadze2, Lara Jablonski1

  • 1Department of Pediatrics I and Center for Translational Neuro- and Behavioral Sciences (C-TBNS), University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

Journal of Neuroendocrinology
|February 10, 2025
PubMed

Insights

Adults born very preterm show altered cortisol awakening response (CAR) and higher stress and anxiety. This suggests long-term neuroendocrine changes linked to prematurity.

Area of Science:

  • Neuroendocrinology
  • Developmental Psychology
  • Psychiatry

Background:

  • Very preterm birth increases risks for neurodevelopmental and psychiatric issues, including anxiety.
  • Altered programming of the hypothalamus-pituitary-adrenal (HPA) axis is associated with stress-related diseases in preterm individuals.
  • The cortisol awakening response (CAR) is a key indicator of HPA axis reactivity and is linked to psychiatric disorders.

Purpose of the Study:

  • To investigate the CAR in adults born very preterm for the first time.
  • To explore the association between CAR, anxiety, and stress in this population.

Main Methods:

  • Saliva samples were collected from 25 very preterm-born adults and 24 term-born controls over two mornings.
  • Cortisol awakening response (CAR) was analyzed using baseline (S1), total output (AUCg), and actual response (AUCi).
  • Anxiety and perceived stress were assessed using validated questionnaires.

Main Results:

  • No significant differences were found in the actual CAR (AUCi).
  • The very preterm group showed lower initial cortisol levels (S1) and reduced total cortisol output (AUCg).
  • Participants born very preterm reported higher trait anxiety and perceived stress, but CAR did not consistently correlate.

Conclusions:

  • Adults born very preterm exhibit long-term alterations in neuroendocrine function, specifically in their cortisol awakening response.
  • These findings highlight potential lasting impacts of prematurity on HPA axis regulation.
  • Further research is warranted to understand the implications of these neuroendocrine changes for long-term health.

Keywords:
anxietycortisol awakening responsedevelopmentstress responsevery preterm infants

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