Adrenocorticotropic hormone and cortisol levels in term infants born with meconium-stained amniotic fluid
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Kaninghat Prasanth
,
Medha Kamat
Abstract
Objective: To evaluate cord blood concentrations of adrenocorticotropic hormone (ACTH) and cortisol in well term infants born with and without meconium-stained amniotic fluid (MSAF) and term infants born with MSAF who experienced respiratory distress (RD).
Study design: This was a prospective observational study. Fifty-four term infants were enrolled in the study in three groups: group 1 consisted of 18 well infants who were born with clear amniotic fluid, group 2 had 18 well infants born with MSAF, and group 3 had 18 infants born with MSAF who experienced RD in the first 24 h of age. Cord blood ACTH and cortisol concentrations were measured in infants born in all three groups. Groups 2 and 3 had serum ACTH and cortisol levels re-measured at 22–26 h of age.
Result: The mean ACTH and cortisol levels at birth in group 3 infants were 18.3 pg/mL and 12.6 mg/dL, respectively. These were significantly lower than those in group 2 infants.
Conclusion: Term infants born with MSAF and who experienced respiratory distress had significantly lower levels of ACTH and cortisol at birth compared with well term infants born with MSAF or clear amniotic fluid. This study suggests that inadequate response of ACTH and cortisol hormones may play a role in the development of respiratory distress in term infants with MSAF.
References
[1] Chiba T, Omori A, Takahashi K, Tanaka K, Kudo K, Manabe M, et al. Correlations between the detection of stress-associated hormone/oxidative stress markers in umbilical cord blood and the physical condition of the mother and neonate. J Obstet Gynaecol Res. 2010;36:958–64.10.1111/j.1447-0756.2010.01292.xSearch in Google Scholar
[2] Cleary G, Wiswell T. Meconium-stained amniotic fluid and the meconium aspiration syndrome: an update. Pediatr Clin North Am. 1998;45:511–29.10.1016/S0031-3955(05)70025-0Search in Google Scholar
[3] Dargaville PA, Copnell B. The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapies and outcome. Pediatrics. 2006;117:1712–21.10.1542/peds.2005-2215Search in Google Scholar
[4] Fernandez E, Watterberg K. Relative adrenal insufficiency in the preterm and term infant. J Perinatol. 2009;29:44–9.10.1038/jp.2009.24Search in Google Scholar
[5] Goland RS, Wardlaw SL, Blum M, Tropper PJ, Stark RI. Biologically active corticotropin-releasing hormone in maternal and fetal plasma during pregnancy. Am J Obstet Gynecol. 1988;159:884–90.10.1016/S0002-9378(88)80162-5Search in Google Scholar
[6] Heckmann M, Wudy S, Haack D, Pohlandt F. Serum cortisol concentrations in ill preterm infants less than 30 weeks gestational age. Acta Paediatr. 2000;89:1098–103.10.1111/j.1651-2227.2000.tb03358.xSearch in Google Scholar
[7] Huysman M, Hokken-Koelega A, De Ridder M, Sauer P. Adrenal function in sick very preterm infants. Pediatr Res. 2000;48: 629–33.10.1203/00006450-200011000-00013Search in Google Scholar PubMed
[8] Kääpä P. Meconium aspiration syndrome (MAS) – Where do we go? Research perspectives. Early Hum Dev. 2009;85:627–9.10.1016/j.earlhumdev.2009.09.014Search in Google Scholar PubMed
[9] Kamath B, Fashaw L, Kinsella J. Adrenal insufficiency in newborns with congenital diaphragmatic hernia. J Pediatr. 2010;156:495–7.10.1016/j.jpeds.2009.10.044Search in Google Scholar PubMed PubMed Central
[10] Li T, Koshy S, Folkesson HG. IL-1beta-induced cortisol stimulates lung fluid absorption in fetal guinea pigs via SGK-mediated Nedd4-2 inhibition. Am J Physiol. Lung Cell Mol Physiol. 2009;296:L527–33.10.1152/ajplung.90506.2008Search in Google Scholar PubMed
[11] Ng P. Effect of stress on the hypothalamic-pituitary-adrenal axis in the fetus and newborn. J Pediatr. 2011;158:41–3.10.1016/j.jpeds.2010.11.012Search in Google Scholar PubMed
[12] Ng P, Lee C, Lam C, Ma K, Fok T, Chan I, et al. Transient adrenocortical insufficiency of prematurity and systemic hypotension in very low birthweight infants. Arch Dis Child Fetal Neonatal Ed. 2004;89:119–26.10.1136/adc.2002.021972Search in Google Scholar PubMed PubMed Central
[13] Poggi SH, Ghidini A. Pathophysiology of meconium passage into the amniotic fluid. Early Hum Dev. 2009;85:607–10.10.1016/j.earlhumdev.2009.09.011Search in Google Scholar PubMed
[14] Soliman A, Taman K, Rizk M, Nasr I, Alrimawy H, Hamido M. Circulating adrenocorticotropic hormone (ACTH) and cortisol concentrations in normal, appropriate-for-gestational-age newborns versus those with sepsis and respiratory distress: cortisol response to low-dose and standard-dose ACTH tests. Metabolism. 2004;53:209–14.10.1016/j.metabol.2003.09.005Search in Google Scholar PubMed
[15] Watterberg K, Gerdes J, Cole C, Aucott S, Thilo E, Mammel M, et al. Prophylaxis of early adrenal insufficiency to prevent bronchopulmonary dysplasia: a multicenter trial. Pediatrics. 2004;114:1649–57.10.1542/peds.2004-1159Search in Google Scholar PubMed
[16] Ziadeh S, Sunna E. Obstetric and perinatal outcome of pregnancies with term labour and meconium-stained amniotic fluid. Arch Gynecol Obstet. 2000;264:84–7.10.1007/s004040000088Search in Google Scholar PubMed
The authors stated that there are no conflicts of interest regarding the publication of this article.
©2014 by De Gruyter
Articles in the same Issue
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- Guest editorial
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- Omega-3 polyunsaturated fatty acids enhance cytokine production and oxidative stress in a mouse model of preterm labor
- Adrenocorticotropic hormone and cortisol levels in term infants born with meconium-stained amniotic fluid
- Measurement of novel biomarkers of neuronal injury and cerebral oxygenation after routine vaginal delivery versus cesarean section in term infants
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- Delivery-related knowledge of mothers of NICU infants compared with well-baby-nursery infants
- Review article
- Mercury exposure in pregnancy: a review
- Original articles - Obstetrics
- A “multi-hit” model of neonatal white matter injury: cumulative contributions of chronic placental inflammation, acute fetal inflammation and postnatal inflammatory events
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- Obstetric anal sphincter injury risk reduction: a retrospective observational analysis
- Adverse perinatal outcomes related to the delivery mode in women with monochorionic diamniotic twin pregnancies
- Letter to the Editor
- The factors associated with the failure of transcatheter pelvic arterial embolization for intractable postpartum hemorrhage
- Congress Calendar
- Congress Calendar
Articles in the same Issue
- Frontmatter
- Guest editorial
- Guest editorial
- Original articles
- Identification and isolation of putative stem cells from the murine placenta
- Target versus actual oxygenation index at initiation of inhaled nitric oxide in neonates with hypoxic respiratory failure: survey results from 128 patient cases
- Omega-3 polyunsaturated fatty acids enhance cytokine production and oxidative stress in a mouse model of preterm labor
- Adrenocorticotropic hormone and cortisol levels in term infants born with meconium-stained amniotic fluid
- Measurement of novel biomarkers of neuronal injury and cerebral oxygenation after routine vaginal delivery versus cesarean section in term infants
- The time-associated impact of the Newborn Influenza Protection Act on infant influenza rates in New York State
- Delivery-related knowledge of mothers of NICU infants compared with well-baby-nursery infants
- Review article
- Mercury exposure in pregnancy: a review
- Original articles - Obstetrics
- A “multi-hit” model of neonatal white matter injury: cumulative contributions of chronic placental inflammation, acute fetal inflammation and postnatal inflammatory events
- Balloon tamponade for the management of postpartum uterine hemorrhage
- The IgG avidity value for the prediction of congenital cytomegalovirus infection in a prospective cohort study
- Obstetric anal sphincter injury risk reduction: a retrospective observational analysis
- Adverse perinatal outcomes related to the delivery mode in women with monochorionic diamniotic twin pregnancies
- Letter to the Editor
- The factors associated with the failure of transcatheter pelvic arterial embolization for intractable postpartum hemorrhage
- Congress Calendar
- Congress Calendar
