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Published on: December 18, 2013
Cortisol Analysis Using a Novel Method of Saliva Collection: Method and Application in Preterm Infants
Marliese Dion Nist1, Nicole Cistone1, Claire Packer1,2
1College of Nursing, The Ohio State University, Columbus, OH, USA.
Insights
Collecting saliva from preterm infants for stress hormone analysis is challenging. Novel flocked polyester swabs efficiently collect sufficient saliva, enabling accurate measurement of the hypothalamic-pituitary-adrenal (HPA) axis response to nursing care.
Area of Science:
- Neonatal research
- Endocrinology
- Physiological stress response
Background:
- Preterm infants face significant stressors activating the hypothalamic-pituitary-adrenal (HPA) axis.
- Measuring cortisol via saliva is crucial for assessing HPA activity, but sample collection is difficult in preterm infants.
Purpose of the Study:
- To develop and validate a novel method for collecting sufficient saliva volumes from preterm infants using flocked polyester swabs.
- To apply this method to investigate HPA axis responses to nursing care in preterm infants.
Main Methods:
- Developed and validated a flocked polyester swab method for saliva collection.
- Collected adult saliva samples (N=24) for method comparison.
- Applied the swab method to collect saliva from preterm infants (N=31) before, and 30- and 60-minutes after nursing care.
Main Results:
- The flocked swab method yielded sufficient saliva volumes from 98% of infant samples (91/93).
- Cortisol level changes post-caregiving were negatively associated with acute procedural stress.
- Cortisol level changes at 60 minutes were negatively associated with caregiving duration.
Conclusions:
- Flocked polyester swabs provide a viable method for collecting adequate saliva volumes for research on HPA axis function in preterm infants.
- Further research is needed to fully understand stressor-HPA axis relationships and influencing factors in this population.
Abstract:
Preterm infants experience frequent stressors that activate the hypothalamic-pituitary-adrenal (HPA) axis. Cortisol can be readily quantified in saliva samples, but sufficient saliva volumes are difficult to collect from preterm infants. We report the development and validation of a novel method to collect saliva using flocked polyester swabs and the application of this method in a study of preterm infants. Saliva samples, collected from adult participants (N = 24), were divided and processed as "standard" aliquots and aliquots absorbed by and extracted from flocked polyester swabs. Cortisol levels in "standard" and "swab" aliquots were compared. We then collected saliva samples from preterm infants (N = 31) using flocked polyester swabs to measure HPA responses to routine, clustered nursing care. Saliva samples were collected from each infant prior to caregiving, 30-min after caregiving, and 60-min after caregiving. Aliquots from the same adult were highly correlated. Sufficient volumes of saliva were extracted from 91 of 93 infant swabs (98%). Changes in cortisol levels from baseline to 30-min and 60-min after caregiving were negatively associated with acute procedural stress, quantified using the Neonatal Infant Stressor Scale. The change in cortisol level from baseline to 60-min after caregiving was negatively associated with caregiving duration. Further research is needed to understand the relationship between caregiving stress exposure and HPA axis responses in preterm infants and to identify the myriad factors that may influence this association. Flocked polyester swabs offer a viable option for the collection of sufficient volumes of saliva to support this research.
