Evidence map›Paper›PMID 30583244›Full record

ArticlePsychoneuroendocrinology2019

Novel method of measuring chronic stress for preterm infants: Skin cortisol.

Amy L D'Agata, Mary B Roberts, Terri Ashmeade, Samia Valeria Ozorio Dutra, Bradley Kane, Maureen W Groer

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In one paragraph

Article in Psychoneuroendocrinology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Amy L D'AgataCollege of Nursing, University of South Florida, 12912 USF Health Drive, Tampa, FL, USA; College of Nursing, University of Rhode Island, 39 Butterfield Rd., Kingston, RI, USA. Electronic address: amydagata@uri.edu.
Mary B RobertsCollege of Nursing, University of Rhode Island, 39 Butterfield Rd., Kingston, RI, USA; Center for Primary Care & Prevention, Care New England Medical Group, Primary Care &, Specialty Services, 111 Brewster St., Pawtucket, RI, USA.
Terri AshmeadeMorsani College of Medicine, 12910 Bruce B. Downs Blvd, Tampa, FL, USA.
Samia Valeria Ozorio DutraCollege of Nursing, University of South Florida, 12912 USF Health Drive, Tampa, FL, USA.
Bradley KaneCollege of Nursing, University of South Florida, 12912 USF Health Drive, Tampa, FL, USA.
Maureen W GroerCollege of Nursing, University of South Florida, 12912 USF Health Drive, Tampa, FL, USA.
University of South Florida · USUniversity of Rhode Island · US

Funding

The association between preterm milk immunobiology and infant healthR21NR013094 · NINR · UNIVERSITY OF SOUTH FLORIDA · PI GROER, MAUREEN EDITH · 2012 to 2013
$401k
NINR NIH HHS R21 NR013094
6 · The paper itself

Abstract

BACKGROUND AND

objectivesInfants who begin life in the medicalized environment of the neonatal intensive care unit (NICU) do so under stressful conditions. Environmental exposures are often abrasive to vulnerable infants, while invasive and noninvasive lifesaving interventions provide additional pain and/or stress. The most commonly selected biomarker to measure stress is cortisol. The skin is the barrier between the external environment and communicates with our neurological, endocrine and immune regulatory networks. To examine if skin cortisol may be a reliable biomarker of stress, NICU stress exposure and repeated measurements of skin cortisol in very preterm infants were examined retrospectively during the first 6 weeks of life. The temporal relationship between skin cortisol and NICU stress exposure was also analyzed. MATERIALS AND

methodsParticipants included 82 preterm infants born weighing less than 1500 g, admitted to a level III NICU, with a mean gestational age of 28.5 weeks. Infants were studied from birth through 6 weeks of life. NICU stress data was collected using the Neonatal Infant Stressor Scale. Skin samples were collected using d-squame tape as soon after birth as possible and every two weeks thereafter.

resultsOn average, infants experienced approximately 43 stressful events per day during the first 6 weeks of life in the NICU. Stress level and cortisol reactivity varied by gestation age. Higher stress resulted in higher cortisol for infant >28 weeks; lower stress scores were associated with higher stress for infants <28 weeks. Stress exposure during 7 days prior to cortisol sampling yielded the highest AUC for the 2 groups. A statistically significant interaction was identified between gestational age and stress exposure during the previous 7 days (p < 0.01).

conclusionThis is the first study to demonstrate skin cortisol as a preterm infant biomarker of chronic stress exposure. For infants with appropriate skin maturation, this non-invasive sampling method provides several benefits. Importantly, this method may be less intrusive and disruptive for preterm infants.

Indexed as

BiomarkersFemaleGestational AgeHumansHydrocortisoneInfantInfant, NewbornInfant, PrematureIntensive Care Units, NeonatalMaleNeonatal ScreeningRetrospective StudiesSkinStress, PhysiologicalStress, PsychologicalBiomarkersHydrocortisoneCortisolNICUPreterm infantsSkin cortisolStress

Identifiers

PMID30583244
PMCPMC6420357
OpenAlexW2904132604

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.