Cord blood cortisol levels and respiratory distress syndrome.
Cord blood cortisol levels were analyzed in 121 neonates, using a "Coat a Count" RIA kit. Forty two appropriate for gestation age (AGA) preterms < 34 weeks who had not received antenatal dexamethasone constituted Group A, 32 AGA preterms < 34 weeks gestation who had received dexamethasone antenatally comprised Group B, while Group C consisted of 47 term normal neonates. Cortisol levels were compared in these 3 groups and correlated to the development of respiratory distress syndrome (RDS). It was observed tht preterms (Groups A and B) had significantly (p < 0.005) lower levels (8.45 +/- 6.31 micrograms/dl) compared to term neonates (11.67 +/- 4.68 micrograms/dl). Antenatal dexamethasone therapy did not significantly alter cortisol levels within the group of preterms. There was a significant difference (p < 0.02) in cortisol levels between those preterms who developed RDS (5.41 +/- 4.91 micrograms/dl) and those who did not (9.58 +/- 6.45 micrograms/dl). Preterms (Grous A and B) who did not develop RDS had cortisol levels comparable to term neonates. There was a significant reduction in the incidence of RDS (p < 0.05) in preterms who had received antenatal dexamethasone. Cord blood cortisol levels < or = 7 micrograms/dl had a positive predictive accuracy of 36.59% and negative predictive accuracy of 93.75% in predicting onset of RDS.
Srivastava
T
T
Division of Neonatology, Bai Jerbai Wadia Hospital for Children, Parel, Bombay.
Merchant
R H
RH
Ambadekar
M C
MC
D016022:Case-Control Studies; D003907:Dexamethasone / Q000627:therapeutic use; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control
D003907:Dexamethasone; D006854:Hydrocortisone