Associations Between Hormonal Biomarkers and Preterm Infant Health and Development During the First 2 Years After Birth

Abstract

Background: Testosterone levels have been used to examine infant boys’ vulnerability to health and developmental problems, following the general theories of gender differences and the theory of extreme male brain of autism. Objectives: As testosterone is a representative androgen hormone and is higher in preterm than full-term infants, we used this steroid to determine if hypothalamic pituitary hormones, testosterone, and cortisol, were related to physical growth, health, and development of very-low-birthweight (VLBW, BW < 1,500 g) infants. Method: For this comparative longitudinal study, 40 VLBW infants were recruited from a neonatal intensive care unit of a tertiary medical center. Data were collected from medical record reviews, questionnaires, and assessments of infant development at 6, 12, and 24 months. We collected saliva at the three time points and measured hormones using enzyme-immunoassays. Results: General and generalized mixed models showed that a 1pg/ml increment of testosterone was related to a −0.42% decrease in body weight, a −0.18% decrease in length, and a −0.10% decrease in head circumference. Cortisol levels were not associated with any outcome variable. The interactions between testosterone and time on physical growth and socioemotional development also occurred. Discussion: Elevated testosterone levels can be a biological risk factor for poor infant growth and development. Theories about the effects of elevated prenatal testosterone could be useful in predicting health and developmental outcomes among VLBW infants. Research beyond the first 2 years will be needed as infants show more socioemotional and behavioral problems as they grow older.

The Variability and Determinants of Testosterone Measurements in Children: A Critical Review

“…However, T levels and the autistic trait scores differed by child sex (Kung et al, 2016). T levels were also expected to be inversely associated with physical growth as high T levels were reported to be a biological risk factor for lower birthweight and gestational age as well as smaller body weight, length, and head circumference in VLBW infants over 24 months after birth (Cho et al, 2012(Cho et al, , 2021. However, T levels were also reported as a protective biological factor as the levels were positively associated with child physical growth.…”

“…These theories hypothesized that exposure to elevated prenatal testosterone (T) levels is a biological risk factor for neurological and behavioral developmental problems. As T is a representative androgen and the levels are almost three times higher in preterm than full-term infants, especially 1-3 months after birth, T has been used to examine if this androgen is associated with health and the development of cognitive, motor, language, socioemotional, and behavioral outcomes in both preterm and full-term children (Cho et al, 2017(Cho et al, , 2021Whitehouse et al, 2012).…”

Trajectories of Early Childhood Skill Development and Maternal Mental Health

“… 6 Longitudinal analyses using the ASQ-SE as a screening tool have been performed in several countries, when involving the general population ( Marks et al, 2019 ), at risk groups ( Keenan et al, 2019 ; Cho et al, 2021 ), and as an evaluation of a randomized controlled trial ( Salisbury et al, 2022 ; Nores et al, 2019 ). …”