ArticleArchives of disease in childhood. Fetal and neonatal edition2021
Absence of relationship between serum cortisol and critical illness in premature infants.
Article in Archives of disease in childhood. Fetal and neonatal edition, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 8 citations in OpenAlex.
- Glucocorticoid trajectories in preterm infants-born too soon, wired differently.The Journal of clinical endocrinology and metabolism · 2026Article
- Stress exposure, stress responses, and short-term outcomes in very preterm neonates: a national cohort study.European journal of pediatrics · 2026Observational
- [Clinical characteristics of late-onset circulatory collapse in preterm infants].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025Article
- Perinatal glucocorticoid sensitivity in the preterm newborn: molecular mechanisms, endogenous determinants, and clinical implications.Frontiers in endocrinology · 2025Review
- Post-natal steroid exposure in very low birthweight neonates and associations with acute kidney injury.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Presumed adrenal insufficiency in neonates treated with corticosteroids for the prevention of bronchopulmonary dysplasia.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundInadequate cortisol production in response to critical illness in extremely preterm infants may exacerbate poor outcomes. Despite commonly measuring cortisol concentration and administering hydrocortisone for presumed adrenal insufficiency, the relationship between serum cortisol concentration and illness severity remains unclear in this unique population.
objectiveTo determine the relationship between cortisol concentrations and illness severity as measured by the Score for Neonatal Acute Physiology II, neonatal Sequential Organ Failure Assessment and Vasoactive-Inotropic Score in premature infants. DESIGN/
methodsThis retrospective, single-center cohort study included preterm infants born <30 weeks gestational age admitted to a level IV neonatal intensive care unit (NICU) between June 2011 and July 2018, who had a serum cortisol obtained for clinical indications before 36 weeks PMA. Demographic data were collected on infants and mothers. Nine clinical variables were identified a priori that could potentially modify cortisol concentration including critical illness. Univariate and multivariable analyses determined the relationship between cortisol concentration and each of these variables.
resultsA total of 224 preterm infants with pretreatment serum cortisol concentration met criteria for inclusion. The median (IQR) gestational age at birth was 25 weeks (24, 26) and at cortisol measurement was 26 weeks (25, 28). The median cortisol was 13.3 ug/dL. Non-survivors had the highest values. Cortisol concentration did not correlate with any of the selected illness severity scores.
conclusionsCortisol concentrations in extremely preterm infants did not correlate with illness severity regardless of gestational age. Further studies are needed to identify clinically useful mediators of adrenal dysfunction and to guide clinical management.
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