Adrenocorticotropic hormone and cortisol levels in term infants born with meconium-stained amniotic fluid.

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.