Salivary cortisol is not associated with dexamethasone response in preterm infants with evolving bronchopulmonary dysplasia.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY Journal of Perinatology Pub Date : 2024-11-21 DOI:10.1038/s41372-024-02177-x

Tamorah Lewis, Erik A Jensen, Sherry Courtney, Jonathan Slaughter, Matthew J Kielt, Narayan Prahbu Iyer, Cheri Gauldin, Christopher Nitkin, Hung-Wen Yeh, William Truog

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Abstract

Objective: Short-term treatment efficacy of systemic dexamethasone (DEX) in preterm infants with bronchopulmonary dysplasia (BPD) is highly variable. Our objective was to assess if salivary cortisol may serve as a reliable biomarker of steroid response.

Study design: Multi-site prospective observational cohort study. Salivary cortisol was measured before and after DEX treatment. Respiratory Severity Score (RSS) quantified clinical response.

Results: Fifty-four infants with median (inter-quartile range) gestational age of 25.1 (24.1,26.5) weeks initiated DEX at 30 (23,48) days' postnatal age. Median baseline and post-treatment cortisol levels were 0.3 (0.2,0.6) μg/dl; 8.3 (5.5,16.5) nmol/L and 0.2 (0.1,0.3) μg/dl; 5.5 (2.8,8.3) nmol/L, respectively. RSS values decreased by a median of 3.1(1.6,5.0) Change in RSS did not correlate with baseline cortisol or change in cortisol levels.

Conclusion: In this first study to assess salivary cortisol as a biomarker for DEX response in BPD, salivary cortisol did not predict dexamethasone response.

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唾液皮质醇与支气管肺发育不良早产儿的地塞米松反应无关。

目的：对于患有支气管肺发育不良（BPD）的早产儿，全身用地塞米松（DEX）的短期疗效变化很大。我们的目的是评估唾液皮质醇是否可作为类固醇反应的可靠生物标志物：研究设计：多地点前瞻性观察队列研究。在DEX治疗前后测量唾液皮质醇。呼吸系统严重程度评分（RSS）量化临床反应：54名胎龄中位数（四分位数间距）为25.1（24.1,26.5）周的婴儿在出生后30（23,48）天开始接受DEX治疗。基线和治疗后皮质醇水平的中位数分别为 0.3 (0.2,0.6) μg/dl; 8.3 (5.5,16.5) nmol/L 和 0.2 (0.1,0.3) μg/dl; 5.5 (2.8,8.3) nmol/L。RSS值下降的中位数为3.1（1.6,5.0），RSS的变化与皮质醇基线或皮质醇水平的变化无关：在这项首次评估唾液皮质醇作为地塞米松对 BPD 反应的生物标志物的研究中，唾液皮质醇不能预测地塞米松的反应。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.