Single course of antenatal steroids did not alter cortisol in preterm infants up to 18 months.
OBJECTIVE
To determine whether a single course of antenatal dexamethasone alters resting cortisol at 3, 8 and 18 months corrected age in preterm infants.


METHODS
Preterm infants born ≤32 weeks gestational age were recruited during 2001-2004 from a single neonatal intensive care unit. Resting salivary cortisol was collected at least once at 3, 8 and 18 months corrected age in a longitudinal cohort. A mixed-effects repeated measures analysis was used to accommodate cases with less than complete follow-up.


RESULTS
One hundred and thirty three infants were included in the present study, contributing 266 cortisol samples. Of these, 107 infants had been exposed to a single course of antenatal dexamethasone and 26 not exposed to antenatal steroids. There was no significant main effect of antenatal steroids on resting cortisol at any age. This result was not altered after adjusting for gestational age at birth, neonatal cumulative pain, morphine exposure, mechanical ventilation days and post-natal steroid exposure.


CONCLUSIONS
No effect of a single course of dexamethasone on resting salivary cortisol, an indicator of hypothalamic-pituitary-adrenal axis function, was found in infancy up to 18 months corrected age in infants born very preterm.
Developmental Neurosciences & Child Health, Child & Family Research Institute, Vancouver, BC, Canada.
Ayala
A
Gover
Susanne
S
Brummelte
Anne R
AR
Synnes
Steven P
SP
Miller
Rollin
R
Brant
Joanne
J
Weinberg
Ruth E
RE
Grunau
D003907:Dexamethasone / Q000008:administration & dosage* / Q000494:pharmacology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D008297:Male; D011295:Prenatal Care; D011446:Prospective Studies; D012463:Saliva / Q000737:chemistry*
D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone