Association of Serum Cortisol Levels with Respiratory Distress Syndrome and Mortality in Premature Babies

Abstract

Objective: To evaluate Trends of cortisol level and its relation with Respiratory distress syndrome and Mortality in premature babies Materials & Methods: A descriptive cross sectional study was conducted in Neonatal unit of pediatric medicine 1 of Bahawalvictoria hospital Bahawalpur from Feb 2021 to June 2021.Premature babies (less than 36 weeks gestation by ballard scoring )admitted in Preterm ward on day 1 were enrolled after informed consent and ruling out exclusion criteria (More than 24 hour old , Who have received antenatal steroids for lung maturation, Received any treatment before admission in any other hospital, Patient having Any obvious anomaly ).Day 1 sample sent for CRP and cortisol. Data recorded regarding weight, gestational age (ballard scoring), septic risk factors. These patients were followed for development of RDS ( on X ray at 24 hour of life). Outcome was documented as expiry, discharged or LAMA. Data analyzed in SPSS 20. Results:40 patients were enrolled as per inclusion criteria. 27 (67.5 % ) were male and 13 (32.5 %) were female. Gestational age 3 (7.5 %) had less than 28 weeks, 29-30 weeks were 6 (15 %), 31-34 weeks were 31 (77.5 %). Weight less than 1.5 kg were 23 (57.5%), 1.5 to2 kg were 15 (37.5 %), 2.1-2.5 kg were 2 (5%). Cortisol level low in 4 (10 %), normal in 6 (15 %), high in 30 (75 %).22 (55 %) discharged, 13 (32 %) expired, and 5 (12.5 %) got LAMA. Cortisol level as compared to outcome has p value 0.002. Tweleve (30 %) had RDS. Twenty two (55 %) had evidence of sepsis. 18 (45 %) had CRP more than 6. Cortisol level as compared to RDS presence has P value 0.057 and with sepsis has P value 0.007. Mean cortisol in discharged patients were 19.8, expired 14.2 and LAMA has 22.7. Mean cortisol in RDS patients were 18.3 and RDS absent had 18.3 also. Mean cortisol in Sepsis positive patients were 18.6 and sepsis absent were 18.0 Conclusion: Mean cortisol has no significant difference in discharged and expired patients.