The Cortisol Serum Measurement as a Marker of Stress in Neonates

Authors

  • Syatirah Jalaluddin Faculty of Medicine and Health Sciences, Alauddin Islamic State University, Makassar, Indonesia
  • Mochammad Hatta Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
  • A. Dwi Bahagia Febriani Department of Pediatrics, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
  • Ema Alasiry Department of Pediatrics, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
  • Suryani As’ad Department of Nutrition, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
  • A. Armyn Nurdin Department of Public Health and Preventive Medicine, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
  • Nadyah Haruna Faculty of Medicine and Health Sciences, Alauddin Islamic State University, Makassar, Indonesia
  • Rosdiana Rahim Faculty of Medicine and Health Sciences, Alauddin Islamic State University, Makassar, Indonesia

Keywords:

Cortisol, newborn, neonatal stress, sepsis, stress marker.

Abstract

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.

Author Biographies

Mochammad Hatta, Department of Microbiology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia

                   

Ema Alasiry, Department of Pediatrics, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia


Suryani As’ad, Department of Nutrition, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia


References

. Bernardo G De, Riccitelli M, Giordano M, et al. Rooming-in Reduces Salivary Cortisol Level of Newborn. 2018;2018.

. Cabral DM, Antonini SRR, Custódio RJ, Martinelli CE, Da Silva CAB. Measurement of salivary cortisol as a marker of stress in newborns in a neonatal intensive care unit. Horm Res Paediatr. 2013;79(6):373-378. doi:10.1159/000351942.

. Morelius E, He HG, Shorey S. Salivary Cortisol Reactivity in Preterm Infants in Neonatal Intensive Care: An Integrative Review. Early Hum Dev. 2016;8(1):337. doi:10.3390/ijerph13030337.

. Cranston CC. A Review of the Effects of Prolonged Exposure to Cortisol on the Regulation of the HPA Axis: Implications for the Development and Maintenance of Posttraumatic Stress Disorder. New School Psychol Bull. 2014;11(1):1-13. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=97255808&site=ehost-live&scope=site.

. Rose’meyer R. A review of the serotonin transporter and prenatal cortisol in the development of autism spectrum disorders. Mol Autism. 2013;4(1):37. doi:10.1186/2040-2392-4-37.

. IDAI. Pedoman pelayanan medis. Pedoman pelayanan medis. 2009:58-61.

. Das B, Agarwal P, Agarwal J, Mishra O. Serum cortisol and thyroid hormone levels in neonates with sepsis. Indian J Pediatr. 2002;69(8):663-665.

. Khashana A. Cortisol Levels Exhibited No Momentous Variations Between Bacterial and Non-Bacterial Neonatal Meningitis in Spite of Affecting the Outcome. 2016. doi:10.17795/iji-41760.Research.

. Ranger M, Zwicker JG, Chau CMY, et al. Neonatal Pain and Infection Relate to Smaller Cerebellum in Very Preterm Children at School Age. J Pediatr. 2015;167(2):292-298.e1. doi:10.1016/j.jpeds.2015.04.055.

. Boonen E, Vervenne H, Meersseman P, et al. Reduced Cortisol Metabolism during Critical Illness. N Engl J Med. 2013;368(16):1477-1488. doi:10.1056/NEJMoa1214969.

. Christian LM. Psychoneuroimmunology in pregnancy: Immune pathways linking stress with maternal health, adverse birth outcomes, and fetal development. Neurosci Biobehav Rev. 2012;36(1):350-361. doi:10.1016/j.neubiorev.2011.07.005.

. Van den Hove DLA, Leibold NK, Strackx E, et al. Prenatal stress and subsequent exposure to chronic mild stress in rats; interdependent effects on emotional behavior and the serotonergic system. Eur Neuropsychopharmacol. 2014;24(4): 595-607. doi:10.1016/j.euroneuro.2013.09.006.

. Kingston D, Tough S, Whitfield H. Prenatal and postpartum maternal psychological distress and infant development: A systematic review. Child Psychiatry Hum Dev. 2012;43(5):683-714. doi:10.1007/s10578-012-0291-4.

. Vinall J, Grunau RE. Impact of repeated procedural pain-related stress in infants born very preterm. Pediatr Res. 2014;75(5):584-587. doi:10.1038/pr.2014.16.

. Vinall J, Miller SP, Bjornson BH, et al. Invasive Procedures in Preterm Children: Brain and Cognitive Development at School Age. Pediatrics. 2014;133(3):412-421. doi:10.1542/peds.2013-1863.

. Brummelte S, Grunau RE, Chau V, et al. Procedural pain and brain development in premature newborns. Ann Neurol. 2012;71(3):385-396. doi:10.1002/ana.22267.

. Róka A, Beko G, Halász J, et al. Changes in serum cytokine and cortisol levels in normothermic and hypothermic term neonates after perinatal asphyxia. Inflamm Res. 2013;62(1):81-87. doi:10.1007/s00011-012-0554-3.

. Khashana A, Ojaniemi M, Leskinen M, Saarela T, Hallman M. Term neonates with infection and shock display high cortisol precursors despite low levels of normal cortisol. Acta Paediatr Int J Paediatr. 2016;105(2):154-158. doi:10.1111/apa.13257.

. Morelius E, Theodorsson E, Nelson N. Salivary Cortisol and Mood and Pain Profiles During Skin-to-Skin Care for an Unselected Group of Mothers and Infants in Neonatal Intensive Care. Pediatrics. 2005;116(5):1105-1113. doi:10.1542/peds.2004-2440.

. Mörelius E, He H-G, Shorey S. Salivary Cortisol Reactivity in Preterm Infants in Neonatal Intensive Care: An Integrative Review. Int J Environ Res Public Health. 2016;13(3):337. doi:10.3390/ijerph13030337.

. Zouikr I, Bartholomeusz MD, Hodgson DM. Early life programming of pain: focus on neuroimmune to endocrine communication. J Transl Med. 2016;14(1):123. doi:10.1186/s12967-016-0879-8.

. Xiong F, Zhang L. Role of the hypothalamic-pituitary-adrenal axis in developmental programming of health and disease. Front Neuroendocrinol. 2013;34(1):27-46. doi:10.1016/j.yfrne.2012.11.002.

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Published

2018-05-24

How to Cite

Jalaluddin, S., Hatta, M., Febriani, A. D. B., Alasiry, E., As’ad, S., Nurdin, A. A., Haruna, N., & Rahim, R. (2018). The Cortisol Serum Measurement as a Marker of Stress in Neonates. International Journal of Sciences: Basic and Applied Research (IJSBAR), 39(1), 51–58. Retrieved from https://gssrr.org/index.php/JournalOfBasicAndApplied/article/view/8998

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