Neonatal hydrocortisone therapy does not have a serious suppressive effect on the later function of the hypothalamus–pituitary–adrenal axis

Publisher： John Wiley & Sons Inc

E-ISSN： 1651-2227|104|5|e195-e199

ISSN： 0803-5253

Source： ACTA PAEDIATRICA, Vol.104, Iss.5, 2015-05, pp. : e195-e199

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

AbstractAimThis study investigated whether providing extremely low birthweight (ELBW) infants with a large amount of hydrocortisone had a serious suppressive effect on the later function of the hypothalamus–pituitary–adrenal (HPA) axis.MethodsWe evaluated the function of the HPA axis in 58 ELBW infants receiving 9.0 ± 7.2 mg/kg of intravenous and 68.1 ± 34.1 mg/kg of oral hydrocortisone using a human corticotropin‐releasing hormone stimulation test. The mean age at investigation was 12.0 ± 5.2 months. The response was judged to be normal when the maximum to minimum ratio of the plasma adrenocorticotropic hormone (ACTH) concentration was >2, the peak value of the serum cortisol concentration was >552 nmol/L, or the increment was >193 nmol/L than baseline concentration.ResultsOf the 58 infants studied, 51 (88%) displayed a normal response to both the ACTH and cortisol secretion and seven infants (12%) who were judged to be poor responders exhibited a peak cortisol value of >386 nmol/L without any episode of adrenal insufficiency.ConclusionProviding ELBW infants with a daily low dose of long‐term hydrocortisone therapy should not lead to a serious suppressive effect on the later function of the HPA axis, regardless of the administration method.