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Submitted on September 20, 2005
Accepted on February 1, 2006
Medical Research Council, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK
* To whom correspondence should be addressed. E-mail: aj{at}mrc.soton.ac.uk.
Context: Experimental studies in animals show that adverse prenatal environments lead to lifelong alterations in the activity of the hypothalamic-pituitary-adrenal axis which mediates the stress response through secretion of glucocorticoid hormones. The extent to which such prenatal hypothalamic-pituitary-adrenal axis adaptations occur in humans is unknown.
Objective: To determine whether smaller but otherwise healthy term babies are more likely to demonstrate increased glucocorticoid responses to psychological stress in childhood.
Design & Participants: A cross-sectional study of 68 boys and 72 girls (aged 7-9 yr) who have been followed since 12 weeks of gestation when their mothers took part in a study of healthy children born in Southampton, UK.
Main outcome measure: Salivary cortisol responses to psychological stress.
Results: In boys, birth weight was inversely related to salivary cortisol responses to stress (r = -0.56, P < 0.001) but not to morning cortisol levels while in girls, morning peak cortisol was inversely related to birth weight (r = -0.36, P < 0.05). These associations were independent of gestational age and potential confounding factors including obesity, social class and educational achievement.
Conclusions: This study suggests that processes occurring during fetal life, resulting in smaller newborns, have a lasting effect on adrenocortical responses to stress in boys and on basal adrenocortical activity in girls. Given the known associations between small alterations in adrenocortical activity and features of the metabolic syndrome such as raised blood pressure and glucose intolerance, these effects warrant further investigation of their potential impact on the future health of pre-pubertal children.
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