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Maternal variables associated with physiologic stress and perinatal complications in preterm infants.
J Neonatal Perinatal Med. 2016 Sep 16; 9(3):271-7.JN

Abstract

OBJECTIVE

Complications of prematurity may be related to dysregulation of the hypothalamic-pituitary-adrenal axis in preterm infants. Increased intrauterine exposure to cortisol may be responsible for adverse prenatal programming and subsequent dysfunction of the infant's hypothalamic-pituitary-adrenal axis. The aim of the study was to describe maternal social variables and their association with infant cortisol levels and complications of prematurity.

METHODS

Preterm infants <32 weeks' gestation were recruited. Primary outcomes were development of complications of prematurity and physiologic stress response, represented by cord blood and salivary cortisol levels on first day of life. Descriptive statistics and comparative analyses were performed.

RESULTS

Fifteen of 31 infants enrolled developed a complication of prematurity. Infants of greater gestational age when prenatal care was established had lower cord blood cortisol (p = 0.009) and trended a higher risk of necrotizing enterocolitis (p = 0.069). Infants whose mothers smoked more showed significantly different salivary cortisol distributions on day 1 (p = 0.037), and were at greater risk for intraventricular hemorrhage (p = 0.018).

CONCLUSIONS

The association between maternal social variables, hypothalamic-pituitary-adrenal axis dysregulation, and complications of prematurity supports the research model of physiologic dysregulation/allostatic load as a mechanism for complications in preterm infants. More research is warranted to investigate associations between maternal social variables, maternal stress levels, and adverse prenatal programming of the infant hypothalamic-pituitary-adrenal axis.

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Authors+Show Affiliations

Dietze TR
Physician Assistant Program, Union College, Lincoln, NE, USA.
Rose FF
Physician Assistant Program, Union College, Lincoln, NE, USA. Division of Science and Mathematics, Union College, Lincoln, NE, USA.
Moore TA
College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA.

MeSH

AdultFemaleFetal BloodHumansHydrocortisoneHypothalamo-Hypophyseal SystemInfant, NewbornInfant, Newborn, DiseasesInfant, PrematureMalePituitary-Adrenal SystemPregnancyPregnancy ComplicationsPregnant WomenPrenatal Exposure Delayed EffectsSalivaSocioeconomic FactorsStress, Psychological

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27589552

Citation

Dietze, Tamara R., et al. "Maternal Variables Associated With Physiologic Stress and Perinatal Complications in Preterm Infants." Journal of Neonatal-perinatal Medicine, vol. 9, no. 3, 2016, pp. 271-7.
Dietze TR, Rose FF, Moore TA. Maternal variables associated with physiologic stress and perinatal complications in preterm infants. J Neonatal Perinatal Med. 2016;9(3):271-7.
Dietze, T. R., Rose, F. F., & Moore, T. A. (2016). Maternal variables associated with physiologic stress and perinatal complications in preterm infants. Journal of Neonatal-perinatal Medicine, 9(3), 271-7. https://doi.org/10.3233/NPM-16915134
Dietze TR, Rose FF, Moore TA. Maternal Variables Associated With Physiologic Stress and Perinatal Complications in Preterm Infants. J Neonatal Perinatal Med. 2016 Sep 16;9(3):271-7. PubMed PMID: 27589552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Maternal variables associated with physiologic stress and perinatal complications in preterm infants. AU - Dietze,Tamara R, AU - Rose,F F, AU - Moore,T A, PY - 2016/9/3/entrez PY - 2016/9/3/pubmed PY - 2017/8/24/medline KW - Allostatic load KW - complications of prematurity KW - cortisol KW - maternal stress KW - prenatal care SP - 271 EP - 7 JF - Journal of neonatal-perinatal medicine JO - J Neonatal Perinatal Med VL - 9 IS - 3 N2 - OBJECTIVE: Complications of prematurity may be related to dysregulation of the hypothalamic-pituitary-adrenal axis in preterm infants. Increased intrauterine exposure to cortisol may be responsible for adverse prenatal programming and subsequent dysfunction of the infant's hypothalamic-pituitary-adrenal axis. The aim of the study was to describe maternal social variables and their association with infant cortisol levels and complications of prematurity. METHODS: Preterm infants <32 weeks' gestation were recruited. Primary outcomes were development of complications of prematurity and physiologic stress response, represented by cord blood and salivary cortisol levels on first day of life. Descriptive statistics and comparative analyses were performed. RESULTS: Fifteen of 31 infants enrolled developed a complication of prematurity. Infants of greater gestational age when prenatal care was established had lower cord blood cortisol (p = 0.009) and trended a higher risk of necrotizing enterocolitis (p = 0.069). Infants whose mothers smoked more showed significantly different salivary cortisol distributions on day 1 (p = 0.037), and were at greater risk for intraventricular hemorrhage (p = 0.018). CONCLUSIONS: The association between maternal social variables, hypothalamic-pituitary-adrenal axis dysregulation, and complications of prematurity supports the research model of physiologic dysregulation/allostatic load as a mechanism for complications in preterm infants. More research is warranted to investigate associations between maternal social variables, maternal stress levels, and adverse prenatal programming of the infant hypothalamic-pituitary-adrenal axis. SN - 1878-4429 UR - https://www.unboundmedicine.com/medline/citation/27589552/Maternal_variables_associated_with_physiologic_stress_and_perinatal_complications_in_preterm_infants_ L2 - https://content.iospress.com/openurl?genre=article&amp;id=doi:10.3233/NPM-16915134 DB - PRIME DP - Unbound Medicine ER -