Consequences of Prematurity on Cortisol Regulation and Adjustment Difficulties: A 9-Year Longitudinal Study

A preterm birth represents a stressful event having potentially negative long-term consequences. Thirty-three children born preterm (<33 weeks gestational age) and eleven full-term children participated in a nine-year longitudinal study. Perinatal Risk Inventory (PERI) was used at birth to assess the perinatal stress. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal (HPA) axis. Mothers reported post-traumatic symptoms on a self-report questionnaire 12 months after their child’s birth and children’s adjustment problems at 9 years of child age on the Child Behavior Checklist. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems. Whereas biological factors (i.e., PERI, cortisol regulation at six months) explained cortisol at nine years, maternal post-traumatic symptoms were predictive of adjustment problems in their child. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development. Further research is needed to understand the exact consequences of premature birth on cortisol regulation and the implication for the child’s development and health.

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The Long-Term Effect of Preterm Birth on Renal Function: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062951 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2951

Author(s):

Ju Sun Heo ◽

Jiwon M. Lee

Keyword(s):

Renal Function ◽

Preterm Birth ◽

Glomerular Filtration ◽

Renal Plasma Flow ◽

Meta Analysis ◽

Full Term ◽

Significant Difference ◽

Preterm Group ◽

Preterm Born

The preterm-born adult population is ever increasing following improved survival rates of premature births. We conducted a meta-analysis to investigate long-term effects of preterm birth on renal function in preterm-born survivors. We searched PubMed and EMBASE to identify studies that compared renal function in preterm-born survivors and full-term-born controls, published until 2 February 2019. A random effects model with standardized mean difference (SMD) was used for meta-analyses. Heterogeneity of the studies was evaluated using Higgin’s I2 statistics. Risk of bias was assessed using the Newcastle–Ottawa quality assessment scale. Of a total of 24,388 articles screened, 27 articles were finally included. Compared to full-term-born controls, glomerular filtration rate and effective renal plasma flow were significantly decreased in preterm survivors (SMD −0.54, 95% confidence interval (CI), −0.85 to −0.22, p = 0.0008; SMD −0.39, 95% CI, −0.74 to −0.04, p = 0.03, respectively). Length and volume of the kidneys were significantly decreased in the preterm group compared to the full-term controls (SMD −0.73, 95% CI, −1.04 to −0.41, p < 0.001; SMD −0.82, 95% CI, −1.05 to −0.60, p < 0.001, respectively). However, serum levels of blood urea nitrogen, creatinine, and cystatin C showed no significant difference. The urine microalbumin to creatinine ratio was significantly increased in the preterm group. Both systolic and diastolic blood pressures were also significantly elevated in the preterm group, although the plasma renin level did not differ. This meta-analysis demonstrates that preterm-born survivors may be subject to decreased glomerular filtration, increased albuminuria, decreased kidney size and volume, and hypertension even though their laboratory results may not yet deteriorate.

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Frontal emotion regulation capacity predicts acute cortisol-responses as well as long term resilience to post-traumatic stress: Evidence from a prospective longitudinal study

Psychoneuroendocrinology ◽

10.1016/j.psyneuen.2019.07.189 ◽

2019 ◽

Vol 107 ◽

pp. 65-66

Author(s):

Reinoud Kaldewaij ◽

Wei Zhang ◽

Mahur Hashemi ◽

Floris Klumpers ◽

Saskia Koch ◽

...

Keyword(s):

Emotion Regulation ◽

Longitudinal Study ◽

Traumatic Stress ◽

Post Traumatic Stress ◽

Prospective Longitudinal Study ◽

Cortisol Responses ◽

Post Traumatic ◽

Prospective Longitudinal

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Treatment of victims of trauma

Advances in Psychiatric Treatment ◽

10.1192/apt.bp.105.000844 ◽

2007 ◽

Vol 13 (5) ◽

pp. 358-368 ◽

Cited By ~ 4

Author(s):

Gwen Adshead ◽

Scott Ferris

Keyword(s):

Acute Stress ◽

Stress Disorders ◽

Ptsd Symptoms ◽

Stress Reactions ◽

Long Term Effects ◽

Post Traumatic Stress ◽

Acute And Chronic Stress ◽

Post Traumatic ◽

Traumatic Symptoms

Not all traumatic events cause post-traumatic stress disorder (PTSD), and people develop PTSD symptoms after events that do not seem to be overwhelmingly traumatic. In order to direct services appropriately, there is a need to distinguish time-limited post-traumatic symptoms and acute stress reactions (that may improve spontaneously without treatment or respond to discrete interventions) from PTSD, with its potentially more chronic pathway and possible long-term effects on the personality. In this article, we describe acute and chronic stress disorders and evidence about the most effective treatments.

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