Prenatal and postnatal inflammation in relation to cortisol levels in preterm infants at 18 months corrected age

Objective<br/><br/>To examine whether early inflammation is related to cortisol levels at 18 months corrected age (CA) in children born very preterm.<br/><br/>Study Design<br/><br/>Infants born ≤ 32 weeks gestational age were recruited in the NICU, and placental histopathology, MRI, and chart review were obtained. At 18 months CA developmental assessment and collection of 3 salivary cortisol samples were carried out. Generalized least squares was used to analyze data from 85 infants providing 222 cortisol samples.<br/><br/>Results<br/><br/>Infants exposed to chorioamnionitis with funisitis had a significantly different pattern of cortisol across the samples compared to infants with chorioamnionitis alone or no prenatal inflammation (F[4,139] = 7.3996, P <.0001). Postnatal infections, necrotizing enterocolitis and chronic lung disease were not significantly associated with the cortisol pattern at 18 months CA.<br/><br/>Conclusion<br/><br/>In children born very preterm, prenatal inflammatory stress may contribute to altered programming of the HPA axis.<br/><br/>Keywords: preterm, chorioamnionitis, funisitis, premature infants, hypothalamic-pituitary-adrenal axis, infection, cortisol, stress