Joke de Graaf1, Erica L T van den Akker2, Richard A van Lingen3, Liesbeth J M Groot Jebbink3, Frank H de Jong4, Ruth E Grunau5, Monique van Dijk6, Dick Tibboel6. 1. Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. Electronic address: Jookdegraaf@hotmail.com. 2. Division of Pediatric Endocrinology, Department of Pediatrics, Erasmus MC, Rotterdam, The Netherlands. 3. Princess Amalia Department of Pediatrics, Department of Neonatology, Isala Clinics, Zwolle, The Netherlands. 4. Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands. 5. Division of Neonatology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. 6. Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands.
Abstract
OBJECTIVE: To test the hypothesis that the diurnal cortisol secretion rhythm of children who as neonates had been hospitalized differs from that of children without a history of neonatal hospital admission and that this rhythm differs between these hospitalized children treated with eithercontinuous morphine infusion or placebo. STUDY DESIGN: A follow-up cohort study was performed with 5-year-old children who as neonates participated in a randomized controlled trial of continuous morphine infusion (born 24-42 weeks' gestation), and a control group of healthy term born (≥ 37 weeks' gestation) children. Five saliva samples over a school day were assayed for cortisol concentrations. The diurnal cortisol rhythm was analyzed with random regression analysis for repeated measurements. RESULTS: Compared with the healthy controls, the trial participants had greater cortisol levels (P = .002) after adjustment for sex and socioeconomic status. The administration of morphine did not affect the cortisol concentrations (P = .66) after adjustment for sex, socioeconomic status, and gestational age at birth. CONCLUSIONS: The finding that former trial participants had greater cortisol levels at 5 years of age supports the concept of long-lasting programming of the hypothalamic-pituitary-adrenal axis. Morphine infusion in the neonatal period did not alter cortisol secretion at 5 years of age.
RCT Entities:
OBJECTIVE: To test the hypothesis that the diurnal cortisol secretion rhythm of children who as neonates had been hospitalized differs from that of children without a history of neonatal hospital admission and that this rhythm differs between these hospitalized children treated with either continuous morphine infusion or placebo. STUDY DESIGN: A follow-up cohort study was performed with 5-year-old children who as neonates participated in a randomized controlled trial of continuous morphine infusion (born 24-42 weeks' gestation), and a control group of healthy term born (≥ 37 weeks' gestation) children. Five saliva samples over a school day were assayed for cortisol concentrations. The diurnal cortisol rhythm was analyzed with random regression analysis for repeated measurements. RESULTS: Compared with the healthy controls, the trial participants had greater cortisol levels (P = .002) after adjustment for sex and socioeconomic status. The administration of morphine did not affect the cortisol concentrations (P = .66) after adjustment for sex, socioeconomic status, and gestational age at birth. CONCLUSIONS: The finding that former trial participants had greater cortisol levels at 5 years of age supports the concept of long-lasting programming of the hypothalamic-pituitary-adrenal axis. Morphine infusion in the neonatal period did not alter cortisol secretion at 5 years of age.
Authors: Martijn J J Finken; Bibian van der Voorn; Jonneke J Hollanders; Charlotte A Ruys; Marita de Waard; Johannes B van Goudoever; Joost Rotteveel Journal: Ann Nutr Metab Date: 2017-03-17 Impact factor: 3.374
Authors: Nynke J van den Hoogen; Thomas J de Geus; Jacob Patijn; Dick Tibboel; Elbert A Joosten Journal: Pediatr Res Date: 2021-01-27 Impact factor: 3.756