Journal of Clinical Endocrinology & Metabolism, Vol 69, 1133-1136, Copyright © 1989 by Endocrine Society

ARTICLES

Serum adrenal steroid concentrations in premature infants

MM Lee, L Rajagopalan, GJ Berg and T Moshang Jr
Division of Endocrinology/Diabetes and Neonatology Children's Hospital, Philadelphia, Pennsylvania 19104.

To evaluate serum adrenal steroid concentrations in preterm infants, 17- hydroxyprogesterone (17-OHP), 17-hydroxypregnenolone, 11-deoxycortisol, cortisol, dehydroepiandrosterone (DHEA), DHEA sulfate, androstenedione, 18-hydroxycorticosterone, and aldosterone values were determined in 9 sick and 13 healthy premature infants. Serum steroid concentrations were compared to previously reported data from healthy full-term infants. 17-OHP, 11-deoxycortisol, and aldosterone values were higher in sick preterm infants than in healthy preterm infants. Compared to healthy full-term infants, the premature infants-had significantly higher 17-hydroxypregnenolone, 17-OHP, and DHEA sulfate concentrations. Cortisol values were not different between the sick and healthy preterm infants and were similar to full-term values. Aldosterone values were also similar between the premature and the full-term infants. The findings of elevated steroid precursors in preterm infants and low cortisol levels in stressed sick preterm infants may indicate a relative immaturity of adrenal enzyme activity and inadequate adrenal reserve for stress.

This article has been cited by other articles:

				J. E. Lee, Y. Moon, M. H. Lee, Y. H. Jun, K. I. Oh, and J. W. Choi Corrected 17-Alpha-Hydroxyprogesterone Values Adjusted by a Scoring System for Screening Congenital Adrenal Hyperplasia in Premature Infants Ann. Clin. Lab. Sci., January 1, 2008; 38(3): 235 - 240. [Abstract] [Full Text] [PDF]

				S. Ben-David, N. Zuckerman-Levin, M. Epelman, Z. Shen-Orr, M. Levin, P. Sujov, and Z. Hochberg Parturition Itself Is the Basis for Fetal Adrenal Involution J. Clin. Endocrinol. Metab., January 1, 2007; 92(1): 93 - 97. [Abstract] [Full Text] [PDF]

				M. M. Kushnir, A. L. Rockwood, W. L. Roberts, E. G. Pattison, W. E. Owen, A. M. Bunker, and A. W. Meikle Development and Performance Evaluation of a Tandem Mass Spectrometry Assay for 4 Adrenal Steroids Clin. Chem., August 1, 2006; 52(8): 1559 - 1567. [Abstract] [Full Text] [PDF]

				P. C. Ng, C. H. Lee, F. L. Bnur, I. H.S. Chan, A. W.Y. Lee, E. Wong, H. B. Chan, C. W.K. Lam, B. S.C. Lee, and T. F. Fok A Double-Blind, Randomized, Controlled Study of a "Stress Dose" of Hydrocortisone for Rescue Treatment of Refractory Hypotension in Preterm Infants Pediatrics, February 1, 2006; 117(2): 367 - 375. [Abstract] [Full Text] [PDF]

				M. Heckmann, M. F. Hartmann, B. Kampschulte, H. Gack, R.-H. Bodeker, L. Gortner, and S. A. Wudy Cortisol Production Rates in Preterm Infants in Relation to Growth and Illness: A Noninvasive Prospective Study Using Gas Chromatography-Mass Spectrometry J. Clin. Endocrinol. Metab., October 1, 2005; 90(10): 5737 - 5742. [Abstract] [Full Text] [PDF]

				K A Neville and J L Walker Precocious pubarche is associated with SGA, prematurity, weight gain, and obesity Arch. Dis. Child., March 1, 2005; 90(3): 258 - 261. [Abstract] [Full Text] [PDF]

				P C Ng, C H Lee, C W K Lam, K C Ma, T F Fok, I H S Chan, and E Wong Transient adrenocortical insufficiency of prematurity and systemic hypotension in very low birthweight infants Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2004; 89(2): F119 - F126. [Abstract] [Full Text] [PDF]

				P C Ng, C H Lee, C W K Lam, K C Ma, I H S Chan, E Wong, and T F Fok Early pituitary-adrenal response and respiratory outcomes in preterm infants Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2004; 89(2): F127 - F130. [Abstract] [Full Text] [PDF]

				P. C. Ng, C. W. K. Lam, C. H. Lee, K. C. Ma, T. F. Fok, I. H. S. Chan, and E. Wong Reference Ranges and Factors Affecting the Human Corticotropin-Releasing Hormone Test in Preterm, Very Low Birth Weight Infants J. Clin. Endocrinol. Metab., October 1, 2002; 87(10): 4621 - 4628. [Abstract] [Full Text] [PDF]

				F. G. Riepe, P. Mahler, W. G. Sippell, and C.-J. Partsch Longitudinal Study of Plasma Pregnenolone and 17-Hydroxypregnenolone in Full-Term and Preterm Neonates at Birth and during the Early Neonatal Period J. Clin. Endocrinol. Metab., September 1, 2002; 87(9): 4301 - 4306. [Abstract] [Full Text] [PDF]

				B. A. Banks, N. Stouffer, A. Cnaan, Y. Ning, J. D. Merrill, R. A. Ballard, P. L. Ballard, and the North American Thyrotropin-Releasing Hormone T Association of Plasma Cortisol and Chronic Lung Disease in Preterm Infants Pediatrics, March 1, 2001; 107(3): 494 - 498. [Abstract] [Full Text]

				P C Ng, C W K Lam, T F Fok, C H Lee, K C Ma, I H S Chan, and E Wong Refractory hypotension in preterm infants with adrenocortical insufficiency Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2001; 84(2): 122F - 124. [Abstract] [Full Text]

				P C Ng The fetal and neonatal hypothalamic-pituitary-adrenal axis Arch. Dis. Child. Fetal Neonatal Ed., May 1, 2000; 82(3): 250F - 254. [Full Text]

				K. L. Watterberg, S. M. Scott, C. Backstrom, K. L. Gifford, and K. L. Cook Links Between Early Adrenal Function and Respiratory Outcome in Preterm Infants: Airway Inflammation and Patent Ductus Arteriosus Pediatrics, February 1, 2000; 105(2): 320 - 324. [Abstract] [Full Text]

				K. L. Watterberg, J. S. Gerdes, K. L. Gifford, and H.-M. Lin Prophylaxis Against Early Adrenal Insufficiency to Prevent Chronic Lung Disease in Premature Infants Pediatrics, December 1, 1999; 104(6): 1258 - 1263. [Abstract] [Full Text]

				M. Heckmann, S. A Wudy, D. Haack, and F. Pohlandt Reference range for serum cortisol in well preterm infants Arch. Dis. Child. Fetal Neonatal Ed., November 1, 1999; 81(3): 171F - 174. [Abstract] [Full Text]

				N Linder, N Davidovitch, A Kogan, A Barzilai, J Kuint, R Mazkeret, and J Sack Longitudinal measurements of 17alpha -hydroxyprogesterone in premature infants during the first three months of life Arch. Dis. Child. Fetal Neonatal Ed., November 1, 1999; 81(3): 175F - 178. [Abstract] [Full Text]

				I. Terai, K. Yamano, N. Ichihara, J. Arai, and K. Kobayashi Influence of spironolactone on neonatal screening for congenital adrenal hyperplasia Arch. Dis. Child. Fetal Neonatal Ed., November 1, 1999; 81(3): 179F - 183. [Abstract] [Full Text]

				P. C. Ng, G. W. K. Wong, C. W. K. Lam, C. H. Lee, M. Y. Wong, T. F. Fok, W. Wong, and D. C. F. Chan Pituitary-Adrenal Response in Preterm Very Low Birth Weight Infants after Treatment with Antenatal Corticosteroids J. Clin. Endocrinol. Metab., November 1, 1997; 82(11): 3548 - 3552. [Abstract] [Full Text] [PDF]

				P. L. Jett, M. H. Samuels, P. A. McDaniel, G. I. Benda, S. H. LaFranchi, J. W. Reynolds, and C. E. Hanna Variability of Plasma Cortisol Levels in Extremely Low Birth Weight Infants J. Clin. Endocrinol. Metab., September 1, 1997; 82(9): 2921 - 2925. [Abstract] [Full Text] [PDF]