Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Division of Neonatology, Department of Pediatrics, Cohen Children's Medical Center, Zucker School of Medicine at Hofstra, Northwell Health, Queens, NY, USA.
Pediatr Res. 2022 Nov;92(5):1470-1478. doi: 10.1038/s41390-022-01983-3. Epub 2022 Feb 16.
Exposure to maternal stress in utero negatively impacts cognitive and behavioral outcomes of children born at term. The neonatal intensive care unit (NICU) can be stressful for preterm infants during a developmental period corresponding to the third trimester of gestation. It is unknown whether stress in the NICU contributes to adverse neurodevelopment among NICU graduates. The aim was to examine the association between salivary cortisol and early neurodevelopment in preterm infants.
We examined the association between cortisol levels during the NICU hospitalization and subsequent performance on the NICU Network Neurobehavioral Scales (NNNS), estimating time-specific associations and considering sex differences.
Eight hundred and forty salivary cortisol levels were measured from 139 infants. Average cortisol levels were inversely associated with NNNS Regulation scores for both male and female infants (β = -0.19; 95% CI: -0.44, -0.02). Critical developmental windows based on postmenstrual age were identified, with cortisol measured <30 weeks PMA positively associated with Habituation and Lethargy scores (β = 0.63-1.04). Critical developmental windows based on chronological age were identified, with cortisol measured in the first week of life inversely associated with Attention score (β = -1.01 for females; -0.93 for males).
Stress in the NICU at specific developmental time points may impact early preterm infant neurodevelopment.
Stress in the neonatal intensive care unit can impact the neurodevelopmental trajectory of premature infants. The impact of stress is different at different points in development. The impact of stress is sexually dimorphic.
胎儿期暴露于母体应激会对足月出生的儿童的认知和行为结果产生负面影响。新生儿重症监护病房（NICU）在对应于妊娠第三个 trimester 的发育时期可能会对早产儿造成压力。目前尚不清楚 NICU 中的压力是否会导致 NICU 毕业生的神经发育不良。目的是研究早产儿唾液皮质醇与早期神经发育之间的关系。
我们研究了 NICU 住院期间皮质醇水平与随后在 NICU 网络神经行为量表（NNNS）上的表现之间的关系，估计了特定时间的关联，并考虑了性别差异。
从 139 名婴儿中测量了 844 个唾液皮质醇水平。平均皮质醇水平与男婴和女婴的 NNNS 调节评分呈负相关（β=-0.19；95%CI：-0.44，-0.02）。根据校正胎龄确定了关键发育窗口期，皮质醇测量值<30 周 PMA 与适应和昏睡评分呈正相关（β=0.63-1.04）。根据实际年龄确定了关键发育窗口期，生命第一周测量的皮质醇与注意力评分呈负相关（女性为β=-1.01；男性为β=-0.93）。
特定发育时间点的 NICU 压力可能会影响早期早产儿的神经发育。
NICU 中的压力会影响早产儿的神经发育轨迹。在不同的发育阶段，压力的影响是不同的。压力的影响存在性别差异。
