Serum cortisol concentrations during induced hypothermia for perinatal asphyxia are associated with neurological outcome in human infants

Rosa T. Scaramuzzo, Matteo Giampietri, Erika Fiorentini, Laura Bartalena, Simona Fiori, Andrea Guzzetta, Mariella Ciampi, Antonio Boldrini, Paolo Ghirri

Research output: Contribution to journalArticlepeer-review

Abstract

Birth asphyxia is a cause of neonatal death or adverse neurological sequelae. Biomarkers can be useful to clinicians in order to optimize intensive care management and communication of prognosis to parents. During perinatal adverse events, increased cortisol secretion is due to hypothalamo-pituitary-adrenal axis activation. We aimed to investigate if cortisol variations during therapeutic hypothermia are associated with neurodevelopmental outcome. We compared 18 cases (neonates with birth asphyxia) with 18 controls (healthy term newborns) and confirmed increased serum cortisol concentrations following the peri-partum adverse event. Among cases, we stratified patients according to neurological outcome at 18 months (group A-good; group B-adverse) and found that after 24h of therapeutic hypothermia serum cortisol concentration was significantly lower in group A vs group B (28.7ng/mL vs 344ng/mL, ∗p=0.01). In group B serum, cortisol concentration decreased more gradually during therapeutic hypothermia. We conclude that monitoring serum cortisol concentration during neonatal therapeutic hypothermia can add information to clinical evaluation of neonates with birth asphyxia; cortisol values after the first 24h of hypothermia can be a biomarker associated with neurodevelopmental outcome at 18 months of age.

Original languageEnglish
Pages (from-to)129-133
Number of pages5
JournalStress
Volume18
Issue number1
DOIs
Publication statusPublished - Jan 1 2015

Keywords

  • Birth asphyxia
  • Cortisol
  • Hypothermia
  • Neurological outcome
  • Newborn
  • Stress

ASJC Scopus subject areas

  • Behavioral Neuroscience
  • Endocrine and Autonomic Systems
  • Physiology
  • Psychiatry and Mental health
  • Neuropsychology and Physiological Psychology
  • Medicine(all)

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