Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands.
Department of Psychiatry, University Medical Center Utrecht, Utrecht, Netherlands.
Biol Res Nurs. 2024 Apr;26(2):240-247. doi: 10.1177/10998004231209429. Epub 2023 Oct 20.
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.
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.
Corrected for sex, delivery by C-section was associated with lower cortisol levels in the children ( = -.42, .028), with an explained variance of 34%.
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.
HPA 轴在婴儿早期发育，但对于早产儿或小于胎龄儿（SGA）儿童的 HPA 轴发育情况，我们知之甚少。因此，本初步研究旨在探讨早产和与出生相关的变量对幼儿皮质醇水平的影响。
采用横断面设计，对 38 名早产儿（<37 周妊娠）进行皮质醇测量，年龄在 3 至 9 岁之间。采用回归分析探讨与早产相关的相关性（早产程度和分娩方式）与皮质醇水平的关系。
校正性别后，剖宫产分娩与儿童皮质醇水平较低相关（=-.42，.028），解释方差为 34%。
剖宫产分娩方式与早产儿皮质醇水平降低（或平坦）有关。这在临床上是相关的，可能具有重要意义，因为 HPA 轴紊乱可能导致儿童后期生活中的发育问题。然而，需要进一步研究以探讨进行剖宫产的潜在指征，这将有助于了解影响早产儿 HPA 轴发育的因素。
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