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Blunted stress response in small for gestational age neonates


Schäffer, L; Müller-Vizentini, D; Burkhardt, T; Rauh, M; Ehlert, Ulrike; Beinder, E (2009). Blunted stress response in small for gestational age neonates. Pediatric Research, 62(5):231-235.

Abstract

There is evidence, that adverse conditions during intrauterine development affect future health of the offspring. Hypothalamus-pituitary-adrenal (HPA) axis dysregulation is assumed to play an important role in the association of small-for-gestational-age (SGA) and the pathogenesis of hypertension and the metabolic syndrome. Stress response patterns in SGA neonates may identify a link with intrauterine induced permanent maladaptation of the HPA axis. Salivary cortisol and cortisone levels were therefore analyzed during resting conditions and in response to a pain induced stress event in SGA (<5 percentile) and appropriate-for-gestational-age (AGA) neonates born >/=34 weeks of gestation. In AGA neonates, salivary cortisol and cortisone levels significantly increased after the stress event (p<0.05). In contrast, SGA infants exhibited a blunted steroid release after stress induction (p=0.76, p=0.65, respectively). No influence of mode of delivery (p=0.93), gender (p=0.21) and gestational age (p=0.57) on stress response patterns was observed in a multiple stepwise regression. SGA neonates show a blunted physiological activation of the HPA axis in response to a stress stimulus. Thus, intrauterine induced alteration of HPA axis regulation appears to persist into the postnatal period and represents a prerequisite for the hypothesis of HPA axis involvement in the fetal origin of adult diseases.

There is evidence, that adverse conditions during intrauterine development affect future health of the offspring. Hypothalamus-pituitary-adrenal (HPA) axis dysregulation is assumed to play an important role in the association of small-for-gestational-age (SGA) and the pathogenesis of hypertension and the metabolic syndrome. Stress response patterns in SGA neonates may identify a link with intrauterine induced permanent maladaptation of the HPA axis. Salivary cortisol and cortisone levels were therefore analyzed during resting conditions and in response to a pain induced stress event in SGA (<5 percentile) and appropriate-for-gestational-age (AGA) neonates born >/=34 weeks of gestation. In AGA neonates, salivary cortisol and cortisone levels significantly increased after the stress event (p<0.05). In contrast, SGA infants exhibited a blunted steroid release after stress induction (p=0.76, p=0.65, respectively). No influence of mode of delivery (p=0.93), gender (p=0.21) and gestational age (p=0.57) on stress response patterns was observed in a multiple stepwise regression. SGA neonates show a blunted physiological activation of the HPA axis in response to a stress stimulus. Thus, intrauterine induced alteration of HPA axis regulation appears to persist into the postnatal period and represents a prerequisite for the hypothesis of HPA axis involvement in the fetal origin of adult diseases.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:06 Faculty of Arts > Institute of Psychology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Obstetrics
Dewey Decimal Classification:150 Psychology
610 Medicine & health
Language:English
Date:2009
Deposited On:07 Nov 2008 13:21
Last Modified:05 Apr 2016 12:32
Publisher:Lippincott Wiliams & Wilkins
ISSN:0031-3998
Publisher DOI:10.1203/PDR.0b013e318191fb44
PubMed ID:18948839
Permanent URL: http://doi.org/10.5167/uzh-5012

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