Alterations of adrenal steroidomic profiles in preterm infants at birth

Travers, Simon; Boileau, Pascal; Lombès, Marc; Pussard, Eric

doi:10.1136/archdischild-2016-312457

Cited by 23 publications

(15 citation statements)

References 37 publications

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“…Cortisone and cortisol have previously been shown to increase with gestational age [8], which was confirmed in our study for boys only; for girls, only cortisol increased. Infants born SGA had lower cortisone but similar cortisol levels compared to AGA infants.…”

Section: Discussionsupporting

confidence: 90%

“…In boys, androstenedione correlated with gestational age. Previous studies show conflicting results, with one finding a correlation [8], and the other no correlation [11] for infants of both genders.…”

Section: Discussionmentioning

confidence: 83%

“…Furthermore, in preterm infants, both 11b-HSD2 activity and cortisone concentration in umbilical venous blood correlate with birth weight standard deviation score (SDS) [7]. Preterm infants exhibit a global deficit in mineralocorticoids, glucocorticoids, and adrenal androgens at birth [8]. Term infants born after intrauterine growth retardation CONTACT Kerstin Allvin kerstin.allvin@vgregion.se Division of Neonatology, the Queen Silvia Children's Hospital, S-416 85 Gothenburg, Sweden This article has been republished with minor changes.…”

Section: Introductionmentioning

confidence: 99%

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Altered umbilical sex steroids in preterm infants born small for gestational age

Allvin

Ankarberg‐Lindgren

Niklasson

et al. 2019

The Journal of Maternal-Fetal & Neonatal Medicine

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Background: Boys born small for gestational age (SGA) are at increased risk of testicular dysgenesis syndrome, and girls born SGA face the risk of polycystic ovary syndrome later in life. Our aim was to study whether neonates born SGA have an altered profile of steroid hormones at birth. Materials and methods: A total of 168 singletons (99 boys, 69 girls) born at 32.0-36.9 gestational weeks were recruited to a population-based, university hospital, single-center study. Of these, 31 infants (17 boys, 14 girls) were born SGA. The concentrations of dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, dihydrotestosterone, estrone, estradiol, cortisone, and cortisol were analyzed in umbilical cord serum with mass spectrometry. Results: Girls born SGA had higher levels of androstenedione than girls born appropriate for gestational age (AGA) (4.0 versus 2.6 nmol/L, p ¼ .002). Boys born SGA had lower levels of estrone than boys born AGA (33 822 versus 62 471 pmol/L, p ¼ .038). Infants born SGA had lower levels of cortisone than infants born AGA, both in girls (340 versus 579 nmol/L, p ¼ .010) and in boys (308 versus 521 nmol/L, p ¼ .045). Furthermore, boys born SGA had a higher cortisol/cortisone ratio than boys born AGA (0.41 versus 0.25, p ¼ .028). Gestational age correlated with DHEAS (boys r ¼ 0.48, p ¼ .000, girls r ¼ 0.35, p ¼ .013), and cortisol (boys r ¼ 0.48, p ¼ .000, girls r ¼ 0.29, p ¼ .039). Conclusions: In moderate-to-late preterm infants born SGA, we observed a different steroid hormone profile in cord serum. Girls born SGA show increased levels of androstenedione and boys born SGA show decreased levels of estrone in cord serum, which could be related to placental aromatase deficiency in intrauterine growth restriction.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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Altered umbilical sex steroids in preterm infants born small for gestational age

Allvin

Ankarberg‐Lindgren

Niklasson

et al. 2019

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Infants born very preterm exhibit a deficit in adrenal steroid synthesis resulting in a sodium wasting phenomenon [6]. This relative adrenocortical insufficiency has been associated with an increased risk of neonatal bronchopulmonary dysplasia or death [7].…”

Section: Methods and Findingsmentioning

confidence: 99%

Prediction of neonatal morbidity and very preterm delivery using maternal steroid biomarkers in early gestation

Patil

Grotegut

Gaikwad³

et al. 2021

PLoS ONE

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Background Preterm delivery is a common pregnancy complication that can result in significant neonatal morbidity and mortality. Limited tools exist to predict preterm birth, and none to predict neonatal morbidity, from early in pregnancy. The objective of this study was to determine if the progesterone metabolites 11-deoxycorticosterone (DOC) and 16-alpha hydroxyprogesterone (16α-OHP), when combined with patient demographic and obstetric history known during the pregnancy, are predictive of preterm delivery-associated neonatal morbidity, neonatal length of stay, and risk for spontaneous preterm delivery prior to 32 weeks’ gestation. Methods and findings We conducted a cohort study of pregnant women with plasma samples collected as part of Building Blocks of Pregnancy Biobank at the Indiana University School of Medicine. The progesterone metabolites, DOC and 16α-OHP, were quantified by mass spectroscopy from the plasma of 58 pregnant women collected in the late first trimester/early second trimester. Steroid levels were combined with patient demographic and obstetric history data in multivariable logistic regression models. The primary outcome was composite neonatal morbidity as measured by the Hassan scale. Secondary outcomes included neonatal length of stay and spontaneous preterm delivery prior to 32 weeks’ gestation. The final neonatal morbidity model, which incorporated antenatal corticosteroid exposure and fetal sex, was able to predict high morbidity (Hassan score ≥ 2) with an area under the ROC curve (AUROC) of 0.975 (95% CI 0.932, 1.00), while the model without corticosteroid and fetal sex predictors demonstrated an AUROC of 0.927 (95% CI 0.824, 1.00). The Hassan score was highly correlated with neonatal length of stay (p<0.001), allowing the neonatal morbidity model to also predict increased neonatal length of stay (53 [IQR 22, 76] days vs. 4.5 [2, 31] days, above and below the model cut point, respectively; p = 0.0017). Spontaneous preterm delivery prior to 32 weeks’ gestation was also predicted with an AUROC of 0.94 (95% CI 0.869, 1.00). Conclusions Plasma levels of DOC and 16α-OHP in early gestation can be combined with patient demographic and clinical data to predict significant neonatal morbidity, neonatal length of stay, and risk for very preterm delivery, though validation studies are needed to verify these findings. Early identification of pregnancies at risk for preterm delivery and neonatal morbidity allows for timely implementation of multidisciplinary care to improve perinatal outcomes.

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“…The fetus in all species studied demonstrates an endogenous glucocorticoid surge (Fowden et al 1998) that, together with increasing production of thyroid hormones and increased peripheral conversion of thyroxine to T3, is responsible for maturation of many enzymes and organ systems prior to birth. Maturation of both cortisol and thyroid hormone secretion are related to gestational age and are blunted in the preterm infant (Ballard et al 1998, Travers et al 2018. The maturational role of glucocorticoids has been harnessed as a fetal treatment in women at risk of preterm birth, resulting in reduced mortality and morbidity in preterm neonates (Liggins & Howie 1972), but the addition of thyroidreleasing hormone to this maternal treatment did not have any additional beneficial effect (Crowther et al 2013a).…”

Section: Potential Effect Of Being Born Preterm On Later Glucose Intomentioning

confidence: 99%

Impact of prematurity for pancreatic islet and beta-cell development

Bloomfield

2018

Journal of Endocrinology

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As increasing numbers of babies born preterm survive into adulthood, it is becoming clear that, in addition to the well-described risks of neurodevelopmental sequelae, there also are increased risks for non-communicable diseases, including diabetes. Epidemiological studies indicate that risks are increased even for birth at late preterm and early term gestations and for both type 1 and type 2 diabetes. Thus, factors related to preterm birth likely affect development of the fetal and neonatal beta-cell in addition to effects on peripheral insulin sensitivity. These factors could operate prior to preterm birth and be related to the underlying cause of preterm birth, to the event of being born preterm itself, to the postnatal care of the preterm neonate or to a combination of these exposures. Experimental evidence indicates that factors may be operating during all these critical periods to contribute to altered development of beta-cell mass in those born preterm. Greater understanding of how these factors impact upon development of the pancreas may lead to interventions or management approaches that mitigate the increased risk of later diabetes.

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Alterations of adrenal steroidomic profiles in preterm infants at birth

Abstract: At birth, VPT infants exhibit a global deficit in mineralocorticoids, glucocorticoids and adrenal androgens that attenuates on day 3 of life. Steroid profiling using LC-MS/MS provides evidence for a partial defect in 11-hydroxylase along with prematurity.

Cited by 23 publications

References 37 publications

Altered umbilical sex steroids in preterm infants born small for gestational age

Altered umbilical sex steroids in preterm infants born small for gestational age

Prediction of neonatal morbidity and very preterm delivery using maternal steroid biomarkers in early gestation

Impact of prematurity for pancreatic islet and beta-cell development

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