Academic journal article International Journal of Child Health and Human Development

Hair Cortisol Levels Suggest Hpa Axis Downregulation at Age 7 Years in Boys Born Very Preterm

Academic journal article International Journal of Child Health and Human Development

Hair Cortisol Levels Suggest Hpa Axis Downregulation at Age 7 Years in Boys Born Very Preterm

Article excerpt

Repeated neonatal procedural pain is associated with higher salivary cortisol levels at ages 8 and 18 months in children bom preterm compared to full-term. At age 7 years in the same cohort, we examined whether hair cortisol, reflecting cumulative ongoing stress, differs in children bom preterm compared to full- term, and if neonatal pain predicts hair cortisol levels in preterms. N=128 children, 83 preterm bom =32 weeks gestation and 45 full-term, were seen at age 7 years. Exclusions: major brain injury and/or impairment, postnatal steroids, current medications for ADHD. Cortisol was assayed from hair samples to reflect stress in the prior two months; mothers completed questionnaires. On ANOVA, hair cortisol levels (log values excluding outliers) were lower in the preterm compared to full-term group (ρ=0·009), and lower in girls than boys (ρ=0·047), controlling for concurrent self-reported mother anxiety and depressive symptoms. Using generalized linear modeling, in preterm boys, but not girls, lower hair cortisol was predicted by greater neonatal pain [number of skin-breaking procedures from birth to term, adjusted for morphine and early illness severity] (ρ=0·0001), independent of days on mechanical ventilation (ρ=0·08), gestational age (ρ=0·76), postnatal infection (ρ=0·38), maternal depression (ρ=0·24) and trait anxiety (ρ=0·02). …

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