Birth weight and postnatal growth in preterm born children are associated with cortisol in early infancy, but not at age 8 years

C.A. Ruys, B. van der Voorn, H.N. Lafeber, M. van de Lagemaat, J. Rotteveel, M.J.J. Finken

Research output: Contribution to JournalArticleAcademicpeer-review


© 2017 Elsevier LtdBackground Preterm birth has been associated with altered hypothalamic-pituitary-adrenal (HPA-) axis activity as well as cardiometabolic diseases and neurodevelopmental impairments later in life. We assessed cortisol from term age to age 8 y in children born preterm, to explore the development of HPA-axis activity in association with intrauterine and early-postnatal growth until 6 mo. corrected age. Methods In 152 children born at a gestational age ≤32 wks. and/or with a birth weight ≤1,500 g, random serum cortisol was assessed at term age (n = 150), 3 mo. (n = 145) and 6 mo. corrected age (n = 144), and age 8 y (n = 59). Salivary cortisol was assessed at age 8 y (n = 75): prior to bedtime, at awakening, 15 min after awakening, and before lunch. Cortisol was analyzed in association with birth weight-standard deviation score (SDS), being born small for gestational age (SGA), and combinations of intrauterine and postnatal growth: appropriate for gestational age (AGA) with or without growth restriction (AGA GR+ or AGA GR−) at 6 mo. corrected age, and SGA with or without catch-up growth (SGA CUG+ or SGA CUG−) at 6 mo. corrected age. Cross-sectional associations at all time points were analyzed using linear regression, and longitudinal associations were analyzed using generalized estimating equations. Results Longitudinally, birth weight-SDS was associated with cortisol (β [95%CI]): lower cortisol over time was seen in infants with a birth weight ≤−2 SDS (−50.69 [−94.27; −7.11], p = 0.02), infants born SGA (−29.70 [−60.58; 1.19], p = 0.06), AGA GR+ infants (−55.10 [−106.02; −4.17], p = 0.03) and SGA CUG− infants (−61.91 [−104.73; −19.10], p = 0.01). In cross-sectional analyses at age 8 y, no associations were found between either serum or salivary cortisol and birth weight-SDS, SGA-status, or growth from birth to 6 mo. corrected age. Conclusion In children born preterm, poor intrauterine and postnatal growth were associated with lower cortisol in early infancy, but not at age 8 y. Even though HPA-axis activity no longer differed between groups at age 8 y, or differences could not be confirmed due to attrition, it is unknown whether the differences found in early infancy could attribute to increased health risks later in life.
Original languageEnglish
Pages (from-to)75-82
Publication statusPublished - 1 Aug 2017
Externally publishedYes


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