Salivary cortisol in preterm infants: Validation of a simple method for collecting saliva for cortisol determination

The relationship between maternal factors and the response of preterm infants to pain and stress experienced during heel puncture while in maternal kangaroo care was investigated. This descriptive study included 42 mothers and their preterm infants cared for in a neonatal unit. Data were collected in the baseline, procedure, and recovery phases. We measured the neonates' facial actions, sleep and wake states, crying, salivary cortisol levels, and heart rate, in addition to the mothers' behavior, salivary cortisol levels, and mental condition. The influence of the maternal explanatory variables on the neonatal response variables were verified through bivariate analysis, ANOVA, and multiple regression. The mothers' behavior and depression and/or anxiety did not affect the neonates' responses to pain and stress, though the mothers' levels of salivary cortisol before the procedure explained the variance in the neonates' levels of salivary cortisol after the procedure (p=0.036). Additionally, the mothers' baseline levels of salivary cortisol along with the neonates' age explained the variance in the neonates' heart rate (p=0.001). The ability of mothers to regulate their own stress contributed to the infants' responses to pain and stress.

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Salivary Cortisol Reactivity in Preterm Infants in Neonatal Intensive Care: An Integrative Review

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph13030337 ◽

2016 ◽

Vol 13 (3) ◽

pp. 337 ◽

Cited By ~ 24

Author(s):

Evalotte Mörelius ◽

Hong-Gu He ◽

Shefaly Shorey

Keyword(s):

Intensive Care ◽

Preterm Infants ◽

Salivary Cortisol ◽

Neonatal Intensive Care ◽

Integrative Review ◽

Cortisol Reactivity

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Nasopharyngeal suctioning does not produce a salivary cortisol reaction in preterm infants

Acta Paediatrica ◽

10.1111/apa.12001 ◽

2012 ◽

Vol 101 (12) ◽

pp. 1206-1210 ◽

Cited By ~ 7

Author(s):

Katrin Ivars ◽

Nina Nelson ◽

Orvar Finnström ◽

Evalotte Mörelius

Keyword(s):

Preterm Infants ◽

Salivary Cortisol

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Assessment and Correction of Stress in Preterm Infants and Their Mothers

10.21203/rs.3.rs-508519/v1 ◽

2021 ◽

Author(s):

Iryna Sarapuk ◽

Halyna Pavlyshyn

Keyword(s):

Preterm Infants ◽

Cortisol Level ◽

Salivary Cortisol ◽

Kangaroo Mother Care ◽

Overall Design ◽

Skin Contact ◽

Salivary Cortisol Level ◽

Baseline Response ◽

Cortisol Levels ◽

Skin To Skin

Abstract The objective was to study the peculiarities of hormonal stress in preterm infants in the NICU and their mothers, and to investigate how skin-to-skin contact influences it. The study included 60 preterm infants with GA˂32 weeks who were treated in NICU and their mothers. The overall design was a baseline-response design. Saliva was collected before (baseline) and after skin-to-skin contact to measure cortisol by enzyme immunoassay method. Infant baseline salivary cortisol level was 0.587 [0.239; 1,714] µg/dL. It was significantly higher in neonates who had invasive ventilation (1.00 [0.38; 2.44]) µg/dL compared to non-ventilated infants (0.335 [0.156; 1.236]) µg/dL, p = 0.022; and positively correlated with the Apgar score at 1st and 5th minutes (r=-0.36; p = 0.011 and r=-0.34; p = 0.017) and duration of ventilation (r = 0.70; p = 0.0000). Maternal baseline salivary cortisol level was 0.212 [0.123; 0.378]µg/dL. There was significant decreasing of salivary cortisol after Kangaroo mother care with skin-to-skin contact in infants (0.162 [0.111; 0.231]) µg/dL, p˂0.001 and mothers (0.096 [0.077; 0.156]) µg/dL, p˂0.001. Conclusion: Preterm infants in the NICU and their mothers experience stress confirmed by the increased baseline cortisol levels. Kangaroo mother care with skin-to-skin contact reduces the stress and normalizes salivary cortisol levels in both infant and mother in the NICU.

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Salivary Cortisol As Indicators of Pain in Preterm Infants

Clinical Nursing Research ◽

10.1177/1054773803259665 ◽

2004 ◽

Vol 13 (1) ◽

pp. 53-68 ◽

Cited By ~ 58

Author(s):

Carolyn J. Herrington ◽

Isoken N. Olomu ◽

Sandra M. Geller

Keyword(s):

Preterm Infants ◽

Salivary Cortisol

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Is the Correlation between Salivary Cortisol and Serum Cortisol Reliable Enough to Enable Use of Salivary Cortisol Levels in Preterm Infants?

American Journal of Perinatology ◽

10.1055/s-0037-1603345 ◽

2017 ◽

Vol 34 (13) ◽

pp. 1302-1305

Author(s):

Katherine Wynne-Edwards ◽

Parthiv Amin ◽

Ruokun Zhou ◽

Arun Sundaram ◽

Tania Martinez-Soto ◽

...

Keyword(s):

Adrenal Insufficiency ◽

Preterm Infants ◽

Salivary Cortisol ◽

Saliva Sample ◽

Serum Cortisol ◽

Relative Adrenal Insufficiency ◽

Free Cortisol ◽

Cortisol Levels ◽

Paired Serum ◽

Gestational Age At Birth

Background Newborn premature infants are susceptible to development of relative adrenal insufficiency following transition from fetal to extrauterine life. However, the best diagnostic test for adrenal insufficiency in neonates has yet to be developed. Objectives and Methods The aim of this study was (1) to assess the feasibility of obtaining sufficient saliva sample to allow measurement of cortisol by liquid chromatography coupled to tandem mass spectrometry and (2) to assess the correlation, if any, between salivary and serum cortisol in preterm infants of ≤32 weeks' gestational age at birth. Results Samples for 230 paired serum and saliva cortisol levels from 90 preterm infants were analyzed. 87.5% of samples collected had sufficient salivary volumes for measurement. Despite being statistically significant (p < 0.0001), the correlation (Spearman r = 0.674) between serum and salivary cortisol was not strong. Conclusion Salivary free cortisol measurement is feasible but cannot be used to accurately reflect serum total cortisol. Further studies comparing salivary free cortisol to serum free cortisol and establishing normative data are needed before salivary cortisol can be used for diagnostic purposes.

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