Reference range for serum cortisol in well preterm infants
Matthias Heckmanna, Stefan A Wudya, Doris Haackb, Frank Pohlandta
a Division of
Neonatology and Paediatric Critical Care
Department of Paediatrics
University of Ulm
Germany, b Department of Pharmacology
University of Heidelberg
Germany
Correspondence to: Professor Frank Pohlandt.
Accepted 14 June 1999
AIM
To establish a
reference range for serum cortisol concentrations in preterm infants
with a gestational age of less than 30 weeks during the first two weeks
of life.
METHODSInfants were
prospectively classified by the following exclusion criteria:
surfactant administration, arterial hypotension, acute or uncontrolled
infection, ventricular haemorrhage II° or above, serum glucose < 2.2 mmol/l, exchange transfusion, stress as a result of any kind of
examination or nursing for at least 4 hours before blood sampling. The
cortisol value was measured once using radioimmunoassay in each infant.
RESULTSIn appropriate
for gestational age (AGA) infants (n = 37, median gestational age 27.7 weeks, median birthweight 1030 g) the distribution of the cortisol
concentrations was non-Gaussian. These had a nearly normal
distribution, when log10 values of the data were used. The
points determined by mean (2 SD) on the logarithmic scale were
transformed back to the original units to provide a reference range:
73-562 nmol/l. Gestational age was significantly (p = 0.033)
associated with cortisol values (log10) with a regression coefficient (standard error) of 
0.045 (0.020). Small for gestational age (SGA) infants (n = 8) had significantly higher cortisol values (median 357 nmol/l) than AGA infants (median 199 nmol/l) (p=0.028).
CONCLUSIONSThere is a
strictly defined reference range of serum cortisol concentrations in
AGA preterm infants.
Keywords: reference range; serum cortisol; preterm
© 1999 by Archives of Disease in Childhood
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