Title:Cord Blood Cortisol Level - A Possible Predictor for Respiratory Distress
Syndrome in Preterm Neonates
Volume: 20
Author(s): Anup John Thomas*, Dhandapany Gunasekaran, Chandrasekaran Venkatesh, Nanda Chhavi and Soundararajan Palanisamy
Affiliation:
- Department of Paediatrics, Mahatma Gandhi Medical College and Research Institute, Puducherry (Pondicherry), Sri
Balaji Vidyapeeth (Deemed to be University), India
Keywords:
Antenatal steroids, Cord blood, Cortisol, Preterm, Respiratory distress syndrome, neonates.
Abstract: Background: Respiratory Distress Syndrome (RDS) is a leading cause of death in premature
infants. There are different clinical/ biochemical markers associated with the RDS. One of
the potential biochemical markers is cortisol in cord blood.
Purpose: This study aims to correlate cortisol levels in preterm neonates with RDS and to establish
whether cord blood cortisol is a reliable predictor for RDS.
Materials and Methods: This prospective analytical study was conducted in a tertiary care hospital
over nine months among fifty preterm neonates. Data were collected using proforma, and cord
blood was collected at the time of delivery. Cortisol levels were compared and correlated to the development
of RDS.
Results and Discussion: The mean ± SD cord blood cortisol level among preterm neonates was
5.97 ± 2.74 (SD) μg/dl. The levels were higher in neonates whose mothers received antenatal
steroids and were significantly lower (2.86 ± 1.66 μg/dl) in those who developed RDS. Association
between cord blood cortisol level and RDS was found with an odds ratio of 57.4, which was
statistically significant.
The percentage of babies developing RDS in mothers not covered with antenatal steroids was significantly
higher than those covered (p-value is 0.000).
The mean cord blood cortisol levels were exceptionally low (1.89 μg/dl) in neonates who expired
compared to those who survived (7.02 μg/dl).
Conclusion: There is an association between cord blood cortisol levels and RDS. Hence, Cord
blood cortisol levels may be used to predict RDS and help initiate early treatment, thus preventing
mortality and morbidity.