The Cortisol Serum Measurement as a Marker of Stress in Neonates

Syatirah Jalaluddin, Mochammad Hatta, A. Dwi Bahagia Febriani, Ema Alasiry, Suryani As’ad, A. Armyn Nurdin, Nadyah Haruna, Rosdiana Rahim


The first few days of life are crucial; the neonates are particularly vulnerable to stress and infection during this period. Stress can cause changes in metabolic and endocrine, including cortisol level. The disease causes an indirect impact on cortisol level through cytokines and enzymes. Elevation of cortisol level can disturb hemostasis and cause long terms complications. This research aimed to compare the difference in cortisol level between healthy and neonatal with high suspicion of sepsis. The study was an observational study using the cross-sectional method, conducted in Ananda mother and child hospital Makassar, from February until April 2018. Sixty neonates who fulfill the criteria were included in the study. They were divided into control group (CG) and patient group (PG). The blood samples in CG were taken a right after birth before the routine procedure was performed. Meanwhile, blood samples in PG were made at the time of diagnosis. The level of serum cortisol was measured Duplo with ELISA.

The average serum cortisol level in CG and PG ranged between 9,98 - 120 ng/mL (average of 55,64 ng/mL) and 125,56 - 273,06 ng/mL (182,09 ng/mL) respectively. The correlation of cortisol level  between PG and CG was statistically significant with p-value 0.000 (p < 0.05), 95% CI -143,59475 – (-109, 31159). In this study, the gender, gestational age, birth weight, length of stay, and Apgar score 5 minutes were not correlated with cortisol level in PG and CG. The only mode of delivery correlated with serum cortisol level with p-value 0.000 (95% CI 34,20958 – 101,67470). The serum cortisol level is an accurate method to indicate neonatal stress, and it is significantly higher in ill neonates compare to the healthy ones. It can be used as a prognostic marker, and continuous monitor of its dynamic changes may help us understand better about the implication of stress in early life.


Cortisol; newborn; neonatal stress; sepsis; stress marker.

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