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. 2024 Apr;26(2):240-247.
doi: 10.1177/10998004231209429. Epub 2023 Oct 20.

A Preliminary Study of Correlates of Premature Birth and Their Influence on Cortisol Levels in Young Children

Sophia Kloosterboer  1 , Fabiënne Bertina Anolda Naber  2 , Hiltje Heyman  3 , Angelique Hoffmann-Haringsma  3   4 , Tibor Markus Brunt  3   5
Affiliations

A Preliminary Study of Correlates of Premature Birth and Their Influence on Cortisol Levels in Young Children

Sophia Kloosterboer et al. Biol Res Nurs. 2024 Apr.

Abstract

Objective: The HPA-axis is programmed during early infancy, but a lot is unknown about the programming of the HPA-axis in prematurely born or small for gestational age (SGA) children. Therefore, the aim of this preliminary study was to investigate the influence of prematurity and variables associated with birth on cortisol levels in young children.

Methods: Cortisol was measured in a cross-sectional design in 38 premature born participants (<37 weeks of gestation), aged between 3 - 9 years old. Correlates of prematurity (degree of prematurity and birth delivery route) were investigated in relationship with cortisol levels with regression analysis.

Results: Corrected for sex, delivery by C-section was associated with lower cortisol levels in the children (ß = -.42, p = .028), with an explained variance of 34%.

Conclusion: Birth delivery route by C-section is associated with lowered (or flattened) cortisol levels in children born prematurely. This is clinically relevant and might have important implications, because an HPA-axis disturbance might lead to developmental problems later on in life. However, future research is necessary to investigate the underlying indications for performing a C-section, which will help to understand factors that influence the HPA-axis development in children born prematurely.

Keywords: cortisol; delivery route; hypothalamic-pituitary-adrenal-axis; prematurity; preterm children.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Cortisol measurements in serum blood of participants plotted in the cortisol curve as adapted from Knutsson et al., 1997. Symbols stand for the cortisol measurements in this study, symbols: Moderate to late premature (32–36 weeks), Very premature (28–32 weeks), Extremely premature (<28 weeks).
See this image and copyright information in PMC

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