Preterm birth and infant diurnal cortisol regulation

David Q. Stoye, James P Boardman, Clive Osmond, Gemma Sullivan, Gillian J. Lamb, Gill S. Black, Natalie Z M Homer, Nina Nelson, Elvar Theodorsson, Rebecca M Reynolds*, Evalotte Mörelius

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

Background: Hypothalamic-pituitary-adrenal (HPA) axis adaptation is a potential mechanism linking early life exposures with later adverse health. This study tested the hypothesis that preterm birth is associated with adaptation of diurnal cortisol regulation across infancy.

Methods: A secondary analysis was conducted of saliva cortisol measured morning, midday and evening, monthly, across infancy, as part of a birth cohort conducted in Linköping, Sweden. Diurnal cortisol regulation of infants born extremely preterm (n=24), very preterm (n=27) and at term (n=130) were compared across infancy through random coefficients regression models.

Results: Compared to infants born at term, infants born extremely preterm (-17.2%, 95% CI: -30.7 to -1.2), but not very preterm (1.7%, -14.1 to 20.4), had a flattened diurnal slope across infancy.

Conclusions: Extremely preterm birth is associated with a flattened diurnal slope in infancy. This pattern of cortisol regulation could contribute to adverse metabolic and neurodevelopmental phenotypes observed in this population.

Original languageEnglish
JournalArchives of Disease in Childhood
Publication statusPublished - 14 Mar 2022


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