Coregulation in Salivary Cortisol During Maternal Holding of Premature Infants

Abstract

The two variables with the highest correlation with the Time 1/Time 2 difference score included antenatal steroids and ambient sound level, which were entered into a linear regression equation as predictor variables. A coregulatory relationship in cortisol levels existed between mothers and infants during holding, which was moderated by sound levels. Nurses in the neonatal intensive care unit (NICU) can facilitate the mother-infant relationship, as reflected in coregulatory measures, by promoting a quiet environment, particularly around mothers who are holding their infants.

Salivary and serum cortisol levels in newborn infants

“…These findings -which are different from those published in the literature-are associated with CBG concentrations comparable to that of adults, 8,16,17 which would confirm that some NBIs have a low cortisol secretion at this stage of life. [6][7][8] Hadjian et al showed, by means of balance of dialysis and an adsorbent technique, a lower capacity in serum proteins to bind cortisol in term NBIs. 7 However, Scott et al, in a sample of 120 preterm NBIs, obtained low cortisol values that could not account for CBG deficit since CBG values determined in 61 NBIs (16 ± 5 mg/L) were only slightly below the normal adult range (19-45 mg/L).…”

“…[6][7][8] Hadjian et al showed, by means of balance of dialysis and an adsorbent technique, a lower capacity in serum proteins to bind cortisol in term NBIs. 7 However, Scott et al, in a sample of 120 preterm NBIs, obtained low cortisol values that could not account for CBG deficit since CBG values determined in 61 NBIs (16 ± 5 mg/L) were only slightly below the normal adult range (19-45 mg/L). 17 It is likely that low serum cortisol levels in some of these infants correspond to a phenomenon of immaturity or to different disappearance times in the adrenal fetal zone associated with low adrenocorticotropic hormone (ACTH) and 3-β-oldehydrogenase levels, as described.…”

“…Salivary secretion was induced by placing 2 drops of 5% citric acid on the tongue, 2 minutes before sample collection. 4,7,8 To avoid interferences, the stimulating agent was administered to all the infants instead of using it only when specimen collection was difficult. 8 Gentle examination of the oral cavity was performed to minimize the risk of contamination with milk that could have interfered with the assay.…”

“…4,5 Cortisol in saliva is a reliable marker of the hypothalamicpituitary-adrenal axis activity; it correlates with plasma cortisol and reflects plasma free cortisol levels. 6 Saliva specimens are relatively easy to collect with a non-invasive technique 6,7 and they can be successfully collected in newborn infants by using different stimulating agents like citric acid 4,7,8 or lemon juice.…”

Niveles de cortisol en la saliva y séricos en recién nacidos

“…Para estimular la secreción de saliva, se colocaron sobre la lengua 2 gotas de ácido cítrico al 5%, 2 minutos antes de la toma de la muestra. 4,7,8 Para evitar interferencias, se empleó el estimulante en todos y no solo en los cuales la recolección fue dificultosa. 8 Se realizó una inspección suave de la boca con el objeto de minimizar el riesgo de contaminación con leche que pudiera interferir en el ensayo.…”