Background: Numerous studies have shown that severity of respiratory distress syndrome may affect the endogenous cortisol secretion in preterm infants. Objective: Is to evaluate the levels of serum cortisol in the 1 st and 3 rd days of life in preterm neonates with respiratory distress syndrome. Patients and methods: This study was carried out in neonatal intensive care unit (NICU) of Benha University Hospital during the period from 2019 till 2020. The study included 45 preterm neonates (23 females and 22 males). The neonates included in the study were divided into three groups: Group I: Preterm neonates without RDS as control (n =15). Group II: Preterm neonates with mild to moderate respiratory distress syndrome, were on continuous positive airway pressure (CPAP) (n =15). Group III: Preterm neonates with severe respiratory distress syndrome, were mechanically ventilated (n=15). Results: In cases received antenatal steroids there was no significant difference between 1 st and 3 rd day's serum cortisol levels. In cases didn't receive antenatal steroids there was highly significant difference between 1 st and 3 rd day's serum cortisol levels. There was significant difference between 1 st day serum cortisol levels and highly significant difference between 3 rd day serum cortisol levels regarding antenatal steroids. Conclusion: Preterm infants respond to the stress at delivery and cortisol production continues in infants with RDS than those without RDS; may be in order to cope with poor pulmonary function and to enhance lung maturity. Antenatal steroids have effective role in decreasing incidence and severity of RDS.
Background: Respiratory distress syndrome (RDS) remains the most important determinant of increasing neonatal morbidity in preterm infants. A low secretory capacity of the adrenal cortex may cause a diminished stress response during the acute illness in preterm infants and could lead to increased morbidity in these infants. Objective: To evaluate the levels of antenatal steroid (cortisol) in the 1 st and 3 rd days of life in preterm neonates with respiratory distress syndrome. Patients and methods: This study was carried out in neonatal intensive care unit (NICU) of Benha University Hospital from June, 2020 to January, 2022. The study included 45 preterm neonates (23 females and 22 males), with gestational age ranged from 30 to 36 weeks, and their weights ranged between 1.100 kg to 2.700 kg (all of them were appropriate for gestational age (AGA) with mean weight 1.800 + 0.300 kg).Results: In the current study, in ROC curve and area under the curve shows that 3 rd day serum cortisol significantly could be used as a predictive measure in cases prognosis with probability of 71% that the assay result for a randomly chosen positive case will exceed the result for a randomly chosen negative case. Among respiratory distress groups (2 and 3) 3 rd day serum cortisol level of 485.5 (nmol/l) was chosen as a cutoff point below which cases with respiratory distress tend to show improvement in prognosis with sensitivity of 80% and specificity of 80%. Conclusion: Preterm infants with severe RDS (mechanically ventilated) release more cortisol, which could be the result of severe stress associated with respiratory distress and positive pressure ventilation. Increased incidence and severity of RDS were noticed more in cesarean section (CS) than in vaginal delivery (VD). Antenatal steroids have effective role in decreasing incidence and severity of RDS.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.