Exposure to antenatal corticosteroids and infant cortisol regulation

Weiss, Sandra J.; Keeton, Victoria; Richoux, Sarah; Cooper, Bruce A.; Niemann, Sandra

doi:10.1016/j.psyneuen.2022.105960

Cited by 7 publications

(2 citation statements)

References 52 publications

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“…Antenatal corticosteroid exposure was not taken into account, given that this is very commonly administered in this population. Limited prior research has examined relationships between antenatal corticosteroids and child basal and reactive cortisol beyond early infancy, with mixed findings (for summary see [53]). Furthermore, we did not examine our data by small for gestational (SGA) status, since we did not have a sufficient sample of infants born SGA.…”

Section: Aim 3: Neonatal Pain-related Stress In Relation To Cortisol ...mentioning

confidence: 99%

Cortisol levels are related to neonatal pain exposure in children born very preterm at age 18 months in two independent cohorts

McLean,

Nakajima,

Chau

et al. 2023

Paediatric and Neonatal Pain

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Exposure to pain‐related stress from frequent invasive procedures in the neonatal intensive care unit (NICU) has been associated with altered physiological stress regulation, neurodevelopment, and behavior in children born very preterm (≤32 weeks gestation). Previously, in a cohort born 2003–2006 (Cohort 1), we found that, at 18 months corrected age (CA), children born extremely low gestational age (ELGA; 24–28 weeks) and very low gestational age (VLGA; 29–32 weeks), had higher pre‐test cortisol levels and a different pattern of cortisol output across a developmental assessment involving cognitive challenge compared to children born full‐term (FT; 39–41 weeks). Also, greater neonatal pain‐related stress exposure among the preterm children was related to higher pre‐test cortisol levels. Given the adverse long‐term effects of neonatal pain in preterm infants and the ensuing rise in clinical concerns to appropriately manage pain in the NICU in recent years, we aimed to examine whether our findings from Cohort 1 would still be evident in an independent cohort (Cohort 2) born 2006–2011 and recruited from the same tertiary NICU in Vancouver, Canada. We also compared the cortisol patterns, clinical and socio‐demographic factors, and their interrelationships between the two cohorts. In Cohort 2, our findings using multi‐level modeling support and extend our earlier findings in Cohort 1, demonstrating that children born ELGA display higher pre‐test cortisol levels than FT. As well, greater cortisol output across assessment was related to more anxiety/depressive behaviors in children born VLGA. Importantly, children born ELGA were exposed to less neonatal pain/stress, mechanical ventilation, and morphine in Cohort 2 than Cohort 1. In both cohorts, however, cortisol levels and patterns were related to neonatal pain/stress and clinical factors (days on mechanical ventilation, overall morphine exposure). Despite less exposure to pain/stress and adverse clinical factors in Cohort 2 compared to Cohort 1, cortisol levels and patterns across cognitive challenge in preterm children at 18‐month CA were consistent across the two independent cohorts. These findings highlight that, despite improvements to neonatal care, children born extremely preterm continue to display altered HPA axis activity, which is associated with their poorer neurodevelopmental and behavioral outcomes.

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Section: Aim 3: Neonatal Pain-related Stress In Relation To Cortisol ...mentioning

confidence: 99%

Cortisol levels are related to neonatal pain exposure in children born very preterm at age 18 months in two independent cohorts

McLean,

Nakajima,

Chau

et al. 2023

Paediatric and Neonatal Pain

View full text Add to dashboard Cite

show abstract

“…Both hypo- and hyper-reactivity of the postnatal HPA axis have been observed in these studies, depending on the species, age of the offspring, and on the type, dose, duration and timing of the maternal glucocorticoid overexposure ( Li et alet al 2013 , Howland et al 2017 , McGowan & Matthews 2018 , Martin et al 2021 ). In human populations, the response of the adult HPA axis to prenatal glucocorticoid overexposure appears to switch from hyper-responsiveness in pre-pubescent children to hypo-responsiveness in young adults with reduced responses to both stressful stimuli and exogenous ACTH administration ( Entringer et al 2009 , Bosch et al 2012 , Howland et al 2017 , Weiss et al 2023 ). A similar decline in postnatal HPA responsiveness with increasing age has also been observed in guinea pigs and sheep after prenatal exposure to synthetic glucocorticoids via maternal treatment ( Liu et al 2001 , Sloboda et al 2002 , 2007 ).…”

Section: Discussionmentioning

confidence: 99%

Prenatal cortisol exposure impairs adrenal function but not glucose metabolism in adult sheep

Davies,

Miles,

Camm

et al. 2023

Journal of Endocrinology

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Adverse environmental conditions before birth are known to program adult metabolic and endocrine phenotype in several species. However, whether increments in fetal cortisol concentrations of the magnitude commonly seen in these conditions can cause developmental programming remains unknown. Thus, this study investigated the outcome of physiological increases in fetal cortisol concentrations on glucose-insulin dynamics and pituitary-adrenal function in adult sheep. Compared to saline treatment, intravenous fetal cortisol infusion for 5 days in late gestation did not affect birthweight but increased lamb body weight at 1-2 weeks after birth. Adult glucose dynamics, insulin sensitivity and insulin secretion were unaffected by prenatal cortisol overexposure, assessed by glucose tolerance tests, hyperinsulinaemic-euglycaemic clamps and acute insulin administration. In contrast, prenatal cortisol infusion induced adrenal hypo-responsiveness in adulthood with significantly reduced cortisol responses to insulin-induced hypoglycaemia and exogenous adrenocorticotropic hormone (ACTH) administration relative to saline treatment. The area of adrenal cortex expressed as a percentage of the total cross-sectional area of the adult adrenal gland was also lower after prenatal cortisol than saline infusion. In adulthood, basal circulating ACTH but not cortisol concentrations were significantly higher in the cortisol than saline treated group. The results show that cortisol overexposure before birth programs pituitary-adrenal development with consequences for adult stress responses. Physiological variations in cortisol concentrations before birth may, therefore, have an important role in determining adult phenotypical diversity and adaptability to environmental challenges.

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Relationships Among Number of Stressors, Perceived Stress, and Salivary Cortisol Levels During the Third Trimester of Pregnancy

Salomon,

Weiss

2024

Journal of Obstetric, Gynecologic & Neonatal Nursing

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Exposure to antenatal corticosteroids and infant cortisol regulation

Cited by 7 publications

References 52 publications

Cortisol levels are related to neonatal pain exposure in children born very preterm at age 18 months in two independent cohorts

Cortisol levels are related to neonatal pain exposure in children born very preterm at age 18 months in two independent cohorts

Prenatal cortisol exposure impairs adrenal function but not glucose metabolism in adult sheep

Relationships Among Number of Stressors, Perceived Stress, and Salivary Cortisol Levels During the Third Trimester of Pregnancy

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